EP1002499A2 - Multi-function surgical instrument tool actuator assembly - Google Patents
Multi-function surgical instrument tool actuator assembly Download PDFInfo
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- EP1002499A2 EP1002499A2 EP99122079A EP99122079A EP1002499A2 EP 1002499 A2 EP1002499 A2 EP 1002499A2 EP 99122079 A EP99122079 A EP 99122079A EP 99122079 A EP99122079 A EP 99122079A EP 1002499 A2 EP1002499 A2 EP 1002499A2
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- European Patent Office
- Prior art keywords
- hub
- instrument
- tool
- actuator
- finger ring
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/32056—Surgical snare instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/178—Syringes
- A61M5/31—Details
- A61M5/315—Pistons; Piston-rods; Guiding, blocking or restricting the movement of the rod or piston; Appliances on the rod for facilitating dosing ; Dosing mechanisms
- A61M5/31511—Piston or piston-rod constructions, e.g. connection of piston with piston-rod
- A61M5/31513—Piston constructions to improve sealing or sliding
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00269—Type of minimally invasive operation endoscopic mucosal resection EMR
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00353—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00362—Packages or dispensers for MIS instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2946—Locking means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Ophthalmology & Optometry (AREA)
- Vascular Medicine (AREA)
- Anesthesiology (AREA)
- Hematology (AREA)
- Pathology (AREA)
- Surgical Instruments (AREA)
Abstract
Description
- The present invention relates to a multi-function surgical instrument. More specifically, the invention provides a surgical tool actuator assembly for a multi-function surgical instrument.
- Currently, multi-function surgical instruments are being utilized by surgeons when performing surgical procedures. These multi-function surgical instruments contain multiple surgical tools within the single instrument which allows the surgeon to perform a procedure without requiring the surgeon to remove and insert multiple instruments within the patient. The incorporation of multiple tools within a single instrument provides efficiencies for the surgeon when performing the procedure.
- There are drawbacks, however, with currently known multi-function surgical instruments. Because multiple tools are incorporated into the single instrument, the mechanism of the surgical instrument that is utilized to operate the tools within the instrument can be complex and/or inefficient to use. Thus, the efficiencies that are obtained for a physician by incorporating multiple tools within a single instrument can be negated by the complexities and/or inefficiencies involved with operating the tools of the instrument.
- Therefore, it would be desirable to provide a multi-function surgical instrument tool actuating assembly that would provide for more efficient use of the tools of the instrument by the surgeon who is utilizing the instrument.
- The present invention is directed to overcoming many of the deficiencies that exist with the tool operating mechanisms of multi-function surgical instruments. The present invention provides an improved tool actuating assembly for a multi-function surgical instrument. The tool actuating assembly of the present invention can be utilized in a variety of differently configured multi-function surgical instruments and can be embodied in various physical configurations.
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- Fig. 1 is a side view of a multi-function surgical instrument that incorporates a first embodiment for a tool actuator assembly in accordance with the present invention.
- Fig. 2 is a cross-sectional view of the multi-function surgical instrument and tool actuator assembly of Fig. 1.
- Fig. 3 is a side view of the surgical instrument of Fig. 1 with the needle exposed from the sheath.
- Fig. 4 is a side view of the surgical instrument of Fig. 1 with the snare loop exposed from the sheath.
- Fig. 5 is a side view of a multi-function surgical instrument that incorporates a second embodiment for the tool actuator assembly of the present invention.
- Fig. 6 is a cross-sectional view of the multi-function surgical instrument and tool actuator assembly of Fig. 5.
- Fig. 7 is a side view of the surgical instrument of Fig. 5 with the needle exposed from the sheath.
- Fig. 8 is a side view of the surgical instrument of Fig. 5 with the snare loop exposed from the sheath.
- Fig. 9 is a top view of a multi-function surgical instrument that incorporates a third embodiment for the tool actuator assembly of the present invention.
- Fig. 10 is a side view of the multi-function surgical instrument of Fig. 9 with both the snare and the injection needle disposed within the sheath.
- Fig. 11 is a top view of the multi-function surgical instrument of Fig. 9 with the injection needle exposed from the sheath.
- Fig. 12 is a top view of the multi-function surgical instrument of Fig. 9 with the snare exposed from the sheath.
- Fig. 13 is a top view of a multi-function surgical instrument that incorporates a fourth embodiment for the tool actuator assembly of the present invention.
- Fig. 14 is a side view of the multi-function surgical instrument of Fig. 13 with both the snare and the injection needle disposed within the sheath.
- Fig. 15 is a top view of the multi-function surgical instrument of Fig. 13 with the injection needle exposed from the sheath.
- Fig. 16 is a top view of the multi-function surgical instrument of Fig. 13 with the snare exposed from the sheath.
- Fig. 17 is a side view of a multi-function surgical instrument that incorporates a fifth embodiment for the tool actuator assembly of the present invention.
- Fig. 18 is a side view of a multi-function surgical instrument that incorporates a sixth embodiment for the tool actuator assembly of the present invention.
- Fig. 19 illustrates the tool actuating member of the embodiment of Fig. 18.
- Fig. 20 illustrates the proximal end of the surgical instrument of Fig. 18.
- Fig. 21 illustrates the tool actuator member of the embodiment of Fig. 18 in a first position where a distal end of an injection needle is not in an operative position.
- Fig. 22 illustrates the tool actuator member of the embodiment of Fig. 18 in a second position where the distal end of the injection needle has been extended from the surgical instrument.
- Fig. 23 illustrates the tool actuator member of the embodiment of Fig. 18 in its second position.
- Fig. 24 illustrates an injector adaptor port that can be utilized with the multi-function surgical instrument of Fig. 18.
- Fig. 25 is a perspective view of a multi-function surgical instrument that incorporates a seventh embodiment for the tool actuator assembly of the present invention.
- Fig. 26 is a side view of the multi-function surgical instrument of Fig. 25.
- Fig. 27 is a side view of the top switching member of the embodiment of Fig. 25.
- Fig. 28 is a bottom view of the top switching member of Fig. 27.
- Fig. 29 is a perspective view of the bottom switching member of the embodiment of Fig. 25.
- Fig. 30 is a top view of the bottom switching member of Fig. 29.
- Fig. 31 is a side view of the top switching member and bottom switching member of Figs. 27-30 in an operable configuration.
- Fig. 32 is a top view of the sliding finger ring assembly of the embodiment of Fig. 25.
- Fig. 33 is a rear view of the sliding finger ring assembly of Fig. 32.
- Fig. 34 is a bottom view of the sliding finger ring assembly of Fig. 32.
- Fig. 35 is a side view of the first instrument hub of the embodiment of Fig. 25.
- Fig. 36 is a top view of the first instrument hub of Fig. 35.
- Fig. 37 is a bottom view of the first instrument hub of Fig. 35.
- Fig. 38 is a rear view of the first instrument hub of Fig. 35.
- Fig. 39 is a perspective view of the tool selection and locking switch in an operable configuration with the first and second instrument hubs of the embodiment of Fig. 25.
- Fig. 40 is a side view of the tool selection and locking switch of Fig. 39.
- Fig. 41 is a cross-sectional view of the surgical instrument of Fig. 25 taken along line 41-41 of Fig. 26.
- Fig. 42 is a perspective view of a multi-function surgical instrument that incorporates an eighth embodiment for the tool actuator assembly of the present invention.
- Fig. 43 is a perspective view of an operable configuration of the first and second actuator buttons, the sliding finger ring assembly, and the first and second instrument hubs of the embodiment of Fig. 42.
- Fig. 44 is a perspective view of an operable configuration of the first and second actuator buttons and the first and second hub engagement members of the embodiment of Fig. 42.
- Fig. 45 is a rear view of the multi-function surgical instrument of Fig. 42.
- Fig. 46 is a cross-sectional view of the multi-function surgical instrument of Fig. 42 taken along line 46-46 of Fig. 45.
- Fig. 47 is a cross-sectional view of the multi-function surgical instrument of Fig. 42 taken along line 47-47 of Fig. 45.
- Fig. 48 is a cross-sectional view of the multi-function surgical instrument of Fig. 42 taken along line 48-48 of Fig. 47.
- Fig. 49 is a cross-sectional view of the multi-function surgical instrument of Fig. 42 taken along line 49-49 of Fig. 45.
- Fig. 50 is a cross-sectional view of the multi-function surgical instrument of Fig. 42 taken along line 50-50 of Fig. 49.
- Fig. 51 is a perspective view of a multi-function surgical instrument that incorporates a ninth embodiment for the tool actuator assembly of the present invention.
- Fig. 52 is a top view of the multi-function surgical instrument of Fig. 51.
- Fig. 53 is a perspective view of the guide bar of the embodiment of Fig. 51.
- Fig. 54 is a top view of the guide bar of Fig. 53.
- Fig. 55 is a side view of the guide bar of Fig. 53.
- Fig. 56 is a front view of the guide bar of Fig. 53.
- Fig. 57 is a bottom view of the guide bar of Fig. 53.
- Fig. 58 is a cross-sectional view of the guide bar of Fig. 53 as taken along line 58-58 of Fig. 57.
- Fig. 59 is a perspective view of the first and second instrument hubs of the embodiment of Fig. 51.
- Fig. 60 is a front view of the first and second instrument hubs of Fig. 59.
- Fig. 61 is a side view of the second instrument hub of Fig. 59.
- Fig. 62 is a bottom view of the first and second instrument hubs of Fig. 59.
- Fig. 63 is a rear view of the first and second instrument hubs of Fig. 59.
- Fig. 64 is a perspective view of the sliding finger ring assembly of the embodiment of Fig. 51.
- Fig. 65 is a front view of the sliding finger ring assembly of Fig. 59.
- Fig. 66 is a top view of the sliding finger ring assembly of Fig. 59.
- Fig. 67 is a perspective view of the hub actuator of Fig. 51.
- Fig. 68 is a perspective view of the finger ring assembly and hub actuator of the embodiment of Fig. 51.
- Fig. 69 is a perspective view of the hub actuator, guide bar, and first and second instrument hubs of the embodiment of Fig. 51
- Fig. 70 is a cross-sectional view of the surgical instrument of Fig. 51 taken along line 70-70 of Fig. 52.
- Fig. 71 is a cross-sectional view of the surgical instrument of Fig. 51 taken along line 71-71 of Fig. 52.
- Fig. 72 is a perspective view of a sheath stress relief member that can be utilized with the multi-function surgical instrument of Fig. 51.
- Fig. 73 is a side view of the sheath stress relief member of Fig. 72.
- Fig. 74 is a front view of the sheath stress relief member of Fig. 72.
- Fig. 75 is a cross-sectional view of the sheath stress relief member of Fig. 72 taken along line 75-75 of Fig. 74.
- Fig. 76 is a side view of a tenth embodiment for the tool actuator assembly of the present invention.
- Fig. 77 is a perspective view of the tool actuator assembly of Fig. 76.
- Fig. 78 illustrates the internal working components of the tool actuator assembly of Fig. 76.
- Fig. 79 illustrates the needle, first locking member, and hub of the tool actuator assembly of Fig. 78.
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- Figure 1 illustrates a first embodiment for a surgical tool actuator assembly in accordance with the principles of the present invention. It should be noted that the present invention can be practiced in any of a variety of different configurations for a surgical instrument where multiple surgical tools are contained within the surgical instrument and the present invention is not limited to being practiced in any particular embodiment for the multi-function surgical instrument itself. A first embodiment for a multi-function surgical instrument and a first embodiment for the tool actuator assembly of the present invention are illustrated in Figure 1.
- As is illustrated in Figure 1,
surgical instrument 100 is a multi-function surgical instrument that contains a firstsurgical tool 150, which is a snare, and a secondsurgical tool 160, which is disclosed in the embodiment of Figure 1 as being an injection needle. As can be seen in Figure 1,surgical instrument 100 includes abody 110, a shaft, or sheath, 120, afinger ring 130, and anactuator button 170. Snare 150 andneedle 160 are disposed withinsheath 120 when both tools are in a non-operative position. Snare 150 andneedle 160 can be any of a variety of known devices and the present invention is not limited to any particular embodiment for the snare and the needle. Additionally, as mentioned previously, the present invention is not limited to an embodiment where the firstsurgical tool 150 is a snare and the secondsurgical tool 160 is a needle. The present invention can be practiced with any of a variety of tools, e.g., a brush, grasper, balloon, cautery tool, basket, etc. -
Body 110 is a generally tubular member that includes a guidingslot 114 in adistal end 112A of thebody 110 and includes athumb ring 140 at aproximal end 112B of the body. Also included inbody 110 isinjection port 132 which is utilized to provide fluid tosurgical instrument 100 for injection into the body of a patient throughneedle 160. Guidingslot 114 is comprised of openings on opposed sides ofbody 110 such that an opening extending throughbody 110 is formed by guidingslot 114.Actuator button 170 is disposed withinbody 110 for sliding motion withinbody 110. As such,actuator button 170 includes ahead portion 172, anelongated stem portion 174, andslot guide 176.Slot guide 176 is comprised of two guide tabs that are disposed on opposed sides ofelongated stem portion 174 and which are received within guidingslot 114 ofbody 110. As such,actuator button 170 is disposed withinbody 110 for sliding motion with respect tobody 110 by positioningslot guide 176 within guidingslot 114. Additionally,actuator button 170 is rigidly attached tosheath 120, which is disposed withinbody 110 for sliding motion with respect tobody 110.Actuator button 170 is utilized to retract a portion ofsheath 120 withinbody 110. As will be further explained, the retraction ofsheath 120 withinbody 110 exposes thedistal end 162 ofneedle 160 beyond thedistal end 122 ofsheath 120. - Sheath, or shaft, 120, in the embodiment of Fig. 1-4, and for the other embodiments disclosed later in this specification or contemplated by those skilled in the art, can be comprised of either a rigid or a flexible structure. The present invention is not limited to any particular physical configuration for sheath, or shaft, 120 and its structure is determined by the particular type of surgical instrument with which the present invention is utilized.
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Finger ring 130 is disposed onbody 110 for sliding motion onbody 110. As will be further explained below,finger ring 130 is attached to snare 150 and controls the movement ofsnare 150 to both retractsnare 150 withinsheath 120 and to extendsnare 150 beyond thedistal end 122 ofsheath 120. - Figure 2 is a cross sectional view of the
surgical instrument 100 of Figure 1 that illustrates the internal connections of thesnare 150,needle 160, andsheath 120 within thesurgical instrument 100. As can be seen in Figure 2,needle 160 is a fixed length needle and is rigidly attached at itsproximal end 164 toinjection port 132. Snare 150 is rigidly attached to snareattachment member 134 offinger ring 130. Snareattachment member 134 includes anaperture 135 that extends therethrough such thatneedle 160 is able to extend throughsnare attachment member 134. - Also illustrated in Figure 2 is the attachment of
sheath 120 toactuator button 170.Proximal end 124 ofsheath 120 is rigidly attached toactuator button 170. Thus, sincesheath 120 is disposed withinbody 110 but is not directly attached tobody 110,sheath 120 is able to be retracted into, and extended from,body 110 by the user slidingactuator button 170 within guidingslot 114 ofbody 110. The methods of attachment ofneedle 160 to body 110 (through attachment to injection port 132),snare 150 toattachment member 134, andactuator button 170 tosheath 120 may be by any of a variety of methods and the present invention is not limited to any particular attachment method. For example, each member may be glued to its respective attachment member or it may be attached by utilizing attachment hardware, such as screws or rivets. - The operation of each tool within
surgical instrument 100 will now be described. Figure 1 illustrates thesurgical instrument 100 in a configuration where both thesnare 150 and theneedle 160 are disposed completely withinsheath 120. As can be seen, in this configuration where both thesnare 150 andneedle 160 are disposed withinsheath 120,finger ring 130 is disposed at theproximal end 112B ofbody 110 andactuator button 170 is disposed at thedistal end 114A of guidingslot 114. - Figure 3 illustrates a configuration for
surgical instrument 100 whereneedle 160 is now exposed from thedistal end 122 ofsheath 120. As can be seen,actuator button 170 has now been moved proximally with respect tobody 110 within guidingslot 114. Sincesheath 120 is rigidly attached toactuator button 170, asactuator button 170 is moved proximally alongbody 110,sheath 120 is retracted withinbody 110. In effect, this decreases the effective length of thesheath 120 that extends from thedistal end 112A ofbody 110. Sinceneedle 160 has a fixed length and its length is selected such that thedistal end 162 ofneedle 160 is disposed withinsheath 120 whensheath 120 is extended frombody 110, any retraction ofsheath 120 withinbody 110 through operation ofactuator button 170 will expose thedistal end 162 ofneedle 160 from thedistal end 122 ofsheath 120. Thus, in order to exposeneedle 160 fromsheath 120,needle 160 is not moved relative tobody 110, however,sheath 120 is moved relative tobody 110, thus exposing thedistal end 162 ofneedle 160 from thedistal end 122 ofsheath 120. In this manner, a surgeon is able to control the extension and retraction ofneedle 160 from the surgical instrument by easily operating an actuator button that controls the movement of thesheath 120 of the surgical instrument. - Figure 4 illustrates the operation of
snare 150. As can be seen in Figure 4, slidingfinger ring 130 has now been moved distally alongbody 110 such thatfinger ring 130 is now in a second position. Sincesnare 150 is rigidly attached tofinger ring 130, any movement offinger ring 130 alongbody 110 will also move the snare the same distance that the finger ring is moved. Thus, asfinger ring 130 is moved to its second position distally alongbody 110, thedistal end 152 ofsnare 150, which is the working part ofsnare 150, is disposed externally fromdistal end 122 ofsheath 120. As was explained earlier, becausesnare attachment member 134, which provides for attachment ofsnare 150 tofinger ring 130, includesaperture 135 therethrough,finger ring 130 is able to be moved onbody 110 without effecting movement ofneedle 160.Finger ring 130 andattachment member 134 merely pass overneedle 160 asneedle 160 is positioned withinaperture 135 in thesnare attachment member 134. Thus, the movement and operation ofsnare 150 through operation offinger ring 130 is independent of the operation ofneedle 160, which is actuated throughactuator button 170. - Thus, the present invention as embodied in Figures 1-4 provides for independent operation of a first surgical tool and a second surgical tool and easily operable mechanisms for independently actuating each tool.
- Additional features that could be included with the embodiment of Figures 1-4 for the operating mechanism for actuating
needle 160 are a biasing means to biasactuator button 170 in its first position, i.e., where thesheath 120 is filly extended frombody 110, and a locking device to lockactuator button 170 in its second position where the actuator button has retractedsheath 120 withinbody 110 to exposeneedle 160 fromsheath 120. These additional features are not required when practicing the present invention but may provide for further assisting an operator of the tool with its operation. - These features would not be limited to any particular embodiment and any of a variety of mechanisms could be utilized to implement these features. For example, a biasing spring could be provided within
body 110 that could cooperate withactuator button 170 in order to biasactuator button 170 in its first position. If an operator desired to moveactuator button 170 to its second position, the operator would merely apply sufficient pressure toactuator button 170 such that the pressure overcame the biasing force that biased theactuator button 170 into its first position. For the locking feature, should it be desired, a locking tab could be provide onactuator button 170 that could cooperate with a locking slot that could be provided onbody 110. As the actuator button was moved proximally within guidingslot 114, the locking tab could ride up and over a cam surface associated with the locking slot and once the locking tab traveled over the cam surface the locking tab could be engaged within the slot that is included onbody 110. When the operator desired to moveactuator button 170 distally alongbody 110 to returnactuator button 170 to its first position, the operator could manually lift the actuator button up and out of the slot on the body which would disengage the locking tab from the locking slot and then the actuator button could be moved back to its first position. Again, the present invention is not required to be practiced with these features and, if these features are incorporated, the present invention is not limited to any particular mechanism for implementing these features. - Figures 5-8 illustrate a second embodiment for a surgical tool actuator assembly in accordance with the present invention. As will further explained, the present invention as embodied in Figures 5-8 operates in a similar manner to the embodiment of Figures 1-4, however, the operating mechanism for retracting
sheath 220 withinbody 210 of multi-functionsurgical instrument 200 is comprised of a different structure. - Similar to the surgical instrument that was described in Figures 1-4,
surgical instrument 200 of Figure 5 also includes abody portion 210, aretractable sheath 220 that is partially disposed withindistal end 212A ofbody portion 210, and a slidingfinger ring 230 that is disposed onbody 210 for sliding motion on the body.Surgical instrument 200 includes a firstsurgical tool 250 which is also disclosed as a snare as in the embodiment of Figures 1-4, and a secondsurgical tool 260 which is disclosed as a needle, also similar to the tool of Figs. 1-4. Again, the present invention may be practiced by utilizing any of a variety of different tools withsurgical instrument 200. -
Surgical tool 200 also includes retractingmember 270. As will be further described, retractingmember 270 is rigidly attached, internal tobody 210, to aproximal end 224 ofsheath 220. Retractingmember 270 incudes anengagement head portion 272 that is disposed at aproximal end 212B ofsurgical instrument 200 and asheath attachment portion 274 that is disposed withinbody 210 at thedistal end 212A ofsurgical instrument 200.Sheath attachment portion 274 includes slot guides 276 which are disposed on opposed sides ofsheath attachment portion 274. As in the embodiment of Figures 1-4, slot guides 276 are received within guidingslot 214 that is included inbody 210 atdistal end 212A ofsurgical instrument 200. - Figure 6 is a cross-sectional view of the
surgical instrument 200 of Figure 5 which illustrates the attachments ofsnare 250,needle 260, andsheath 220 to thesurgical instrument 200. As in the embodiment of Figures 1-4,needle 260 is comprised of a fixed length member and is rigidly attached toinjection port 232 that is disposed in theproximal end 212B ofsurgical instrument 200.Injection port 232 is utilized to provide a fluid that is to be injected into the body of a patient toinjection needle 260. Also as was described previously for the embodiment of Figures 1-4, snare 250 is rigidly attached to snareattachment member 234 which is included in slidingfinger ring 230. Snareattachment member 234 includes afirst aperture 235 which extends completely therethrough such thatneedle 260 can extend throughsnare attachment member 234 for rigid attachment toinjection port 232.Sheath 220 is rigidly attached at itsproximal end 224 tosheath attachment portion 274 of retractingmember 270.Sheath attachment portion 274 of retractingmember 270 is connected toengagement head portion 272 of retractingmember 270 byretraction connecting member 278.Retraction connecting member 278 is an elongated member that rigidly connectssheath attachment portion 274 toengagement head portion 272.Retraction connecting member 278 is disposed withinhollow body 210 ofsurgical instrument 200. Snareattachment member 234 includes asecond aperture 236 through which extendsretraction connecting member 278. - As can be seen in Figure 6,
engagement head portion 272 of retractingmember 270 is disposed onbody 210 ofsurgical instrument 200 to the rear of the twofinger rings 238 that are included on slidingfinger ring assembly 230.Biasing member 280 is disposed withinbody 210 ofsurgical instrument 200 and is utilized to bias retractingmember 270 to a first position which, as will be explained, fully extendssheath 220 frombody 210 ofsurgical instrument 200. - The operation of the tools of
surgical instrument 200 will now be explained. As is illustrated in Figure 5, both thesnare 250 andneedle 260 are fully retracted withinsheath 220 ofsurgical instrument 200. As such, slidingfinger ring 230 is in a first position at theproximal end 212B ofbody 210 and the retractingmember 270, and consequently slot guides 276 of retractingmember 270, are in a first position where slot guides 276 are positioned at thedistal end 214A of guidingslot 214 inbody 210. Thus, in this first position for retractingmember 270,sheath 220 is fully extended frombody 210 of thesurgical instrument 200. - Figure 7 illustrates a configuration for the
surgical instrument 200 where theneedle 260 has been exposed fromsheath 220. As can be seen, thedistal end 262 ofneedle 260 extends beyond thedistal end 222 ofsheath 220. In order to extenddistal end 262 ofneedle 260 fromsheath 220, an operator moves slidingfinger ring assembly 230 proximally alongbody 210 of thesurgical instrument 200. Proximal motion of slidingfinger ring assembly 230 will result in engagement of thefinger ring assembly 230 withengagement head portion 272 ofretraction member 270. Asfinger ring assembly 230 continues its movement proximally alongbody 210,finger ring assembly 230 will also moveretraction member 270 proximally alongbody 210. Pressure applied by a user to move slidingfinger ring assembly 230 proximally alongbody 210 will forcerefraction member 270 proximally alongbody 210 against the force applied by biasingmember 280, whichbiases retraction member 270 in its first position. By movingretraction member 270 proximally alongbody 210,sheath attachment portion 274, which is connected toengagement head 272 ofretraction member 270 throughretraction connecting member 278, is also moved proximally withinguide slot 214 ofbody 210. Sincesheath 220 is rigidly attached tosheath attachment portion 274, proximal motion ofsheath attachment portion 274 will retract sheath 220 a distance withinbody 210. Retraction ofsheath 220 withinbody 210 will exposedistal end 262 ofneedle 260 from thedistal end 222 ofsheath 220. Thus, through proximal motion of slidingfinger ring assembly 230,retraction member 270 is moved proximally with respect tobody 210 which in turn retractssheath 220 intobody 210. The retraction ofsheath 220 withinbody 210 exposes thedistal end 262 ofneedle 260 from thedistal end 222 ofsheath 220. Once the operator removes the force from slidingfinger ring assembly 230 that moved the sliding finger ring assembly proximally alongbody 210, biasingmember 280biases retracting member 270 back to its first position which in-turn fully extendssheath 220 frombody 210 which then positions thedistal end 262 ofneedle 260 withinsheath 220. - As with the embodiment as described in Figures 1-4, the
snare 250 of the embodiment of Figures 5-8 is operated independently of theneedle 260. Figure 5 illustrates a configuration for thesurgical instrument 200 where thesnare 250 is fully retracted withinsheath 220. In this configuration, slidingfinger ring assembly 230 is in a first position where thefinger ring assembly 230 is disposed at theproximal end 212B ofbody 210. In order to extend adistal portion 252 ofsnare 250, which is the working portion ofsnare 250, fromsheath 220, the operator would distally move slidingfinger ring assembly 230 alongbody 210, as shown in Fig. 8. Becausesnare 250 is rigidly attached to slidingfinger ring assembly 230, the distal movement of slidingfinger ring assembly 230 will distally movesnare 250 and will thus extend thedistal portion 252 ofsnare 250 fromsheath 220. Because apertures have been provided insnare attachment member 234, fingerring assembly ring 230 is able to slide alongbody 210 and not effect motion ofneedle 260. - Thus, the embodiment for the tool actuator assembly of Figs. 5-8 provides for independent operation of the individual tools of the multi-function surgical instrument and an easily operable mechanism for the user for actuating each tool.
- Figures 9-12 illustrate a third embodiment for the tool actuator assembly of the present invention. As can be seen in Figures 9 and 10,
surgical instrument 300 includes abody portion 310, ahousing 320, a firstsurgical tool 350, which is illustrated as a snare, and a secondsurgical instrument 360, which is illustrated as an injection needle. Arranged for sliding motion onbody 310 is slidingfinger ring assembly 330. Housing 320 can be either integrally formed withbody portion 310 or can be detachably connected tobody portion 310 such as by utilizing a threaded male/female connection such as illustrated with connection joint 315. Connection joint 315 is illustrated as including a threaded male portion that is disposed at adistal end 310B ofbody 310 which is received within an internally threaded female portion that is included in a proximal end ofhousing 320. However, as mentioned previously, the present invention is not limited to any particular configuration for joininghousing portion 320 tobody portion 310. - As is illustrated in Figure 9,
housing 320 includes afirst channel 322 and asecond channel 324. Disposed withinfirst channel 322 ispulley cable 323 and disposed withinsecond channel 324 isneedle hub 362.Pulley cable 323 includes a gear tooth portion 323B and is rigidly attached to either slidingfinger ring assembly 330 or snare 350 at itsproximal end 323A.Proximal end 323A ofpulley cable 323, as described above, can be rigidly attached to either slidingfinger ring assembly 330 or to snare 350 and the present invention is not limited to any particular attachment point forproximal end 323A ofpulley cable 323. The only requirement is thatpulley cable 323 be attached either directly or indirectly to slidingfinger ring assembly 330 such that as the slidingfinger ring assembly 330 is moved distally alongbody portion 310 thepulley cable 323 is also moved distally. As will be further explained, gear teeth 323B ofpulley cable 323 engage withgear 370.Pulley cable 323 is a rigid member such that as force is applied topulley cable 323, the pulley cable moves as a rigid body in response to that application of force. - Disposed within
second channel 324 isneedle hub 362.Needle hub 362 includesgear teeth 364 which also engage withgear 370, as will be further explained.Injection needle 360 is rigidly attached toneedle hub 362.Needle hub 362 is disposed for slidable motion withinsecond channel 324. As can be seen,injection port 366 is also provided inneedle hub 362. The purpose ofinjection port 366 is to be able to provide fluid that is to be injected into the body of a patient toneedle 360. As can be seen in Figure 10, aslot 320A is provided inhousing 320 in order to permitneedle hub 362 to slidably move withinhousing 320. - Second
surgical tool 350, which is a snare device, is disposed withinhousing 320 and extends throughbody 310 where it is rigidly attached to slidingfinger assembly 330. As such, snare 350 passes throughslot 362A that is provided inneedle hub 362.Slot 362A inneedle hub 362 can be seen in Figure 10. Thedistal portion 350B ofsnare needle 360 are disposed withinsheath 328 when both tools are in a non-operative position. - The operation of the tool actuator assembly of the present invention as embodied in Figures 9-12 will now be described. Figures 9 and 10 illustrate the
surgical instrument 300 in a configuration where both thesnare 350 and theinjection needle 360 are disposed completely withinsheath 328 of thesurgical instrument 300. Figure 11 illustrates a configuration forsurgical instrument 300 whereneedle 360 has been extended fromsheath 328 of thesurgical instrument 300. In order to extendneedle 360 fromdistal end 328A ofsheath 328, the operator slidesfinger ring assembly 330 proximally alongbody 310 to theproximal end 310A ofbody 310 as shown in Fig. 11. By slidingfinger ring assembly 330 in a proximal direction,pulley cable 323 is also moved proximally sincepulley cable 323 is rigidly connected, either directly or indirectly as described previously, tofinger ring assembly 330. The proximal motion ofpulley cable 323 causes engagement teeth 323B ofpulley cable 323 to engage withgear 370. The proximal motion of gear teeth 323B causesgear 370 to rotate counter-clockwise withinhousing 320. Asgear 370 rotates counter-clockwise, becausegear 370 is also in engagement withgear teeth 364 that are included onneedle hub 362, the counter-clockwise rotation ofgear 370 will causeneedle hub 362 to move in a distal direction withinchannel 324. Sinceneedle 360 is rigidly attached to the distal end ofneedle hub 362, the distal motion ofneedle hub 362 withinchannel 324 will extend thedistal end 360B ofneedle 360 from thedistal end 328A ofsheath 328. Thus, through proximal motion offinger ring assembly 330, the inter-action of pulley cable gear teeth 323B,gear 370, andgear teeth 364 ofneedle hub 362 will extendneedle 360 fromsheath 328. - To retract
needle 360 back intosheath 328, the slidingfinger ring assembly 330 is moved distally alongbody 310 to its original position as shown in Figs. 9 and 10 wheresnare 350 is still retracted intosheath 328. When slidingfinger ring assembly 330 is moved distally to this position, the pulley teeth 323B will engage withgear 370 to rotategear 370 in a clockwise direction which in-turn will moveneedle hub 362 in a proximal direction which will retractneedle 360 back intosheath 328. - Figure 12 illustrates a configuration for
surgical instrument 300 wheresnare 350 has been extended outside ofsheath 328. In order to extendsnare 350 fromsheath 328, an operator will slidefinger ring assembly 330 in a distal direction alongbody 310 beyond its position as illustrated in Figs. 9 and 10. As is illustrated in Figure 12,finger ring assembly 330 has been moved by an operator to thedistal end 310B ofbody 310. The motion offinger ring assembly 330 distally alongbody 310 causes engagement teeth 323B ofpulley cable 323 to extend distally beyondgear 370 and through an aperture that is provided in the distal end ofhousing 320. Thus,pulley cable 323 is no longer engaged withgear 370 and causes no rotation ofgear 370. Sincegear 370 is engaged withneedle hub 362 and sincegear 370 is not rotated bypulley cable 323 whenfinger ring assembly 330 has been moved distally alongbody 310, theneedle hub 362, and consequently,needle 360, are not moved when the slidingfinger ring 330 is moved distally alongbody member 310. However, sincesnare 350 is rigidly and directly attached to slidingfinger ring assembly 330, the movement offinger ring assembly 330 in a distal direction alongbody 310 will also movesnare 350 in a distal direction and will thus exposedistal end 350A of thesnare 350, which is the working end of the snare, from thedistal end 328A ofsheath 328. Thus, through movement offinger ring assembly 330 distally alongbody 310,snare 350 is exposed fromsheath 328 ofsurgical instrument 300. - To retract
snare 350 back intosheath 328, the operator slidesfinger ring assembly 330 proximally alongbody 310 to the position illustrated in Figs. 9 and 10. - Figures 13-16 illustrate a fourth embodiment for the tool actuator assembly of the present invention. As will be seen, the actuating assembly of Figures 13-16 operates in a similar fashion to the actuating assembly that was disclosed in Figures 9-12, however, the configuration of the pulley cable and the engagement gear are modified in the embodiment of Figures 13-16. The configuration of the
surgical instrument 400 with respect to the attachment of the snare and the needle assembly within the surgical tool are similar for the fourth embodiment of Figures 13-16. - As can be seen in Figure 13,
surgical instrument 400 again comprises abody portion 410 and ahousing 420.Housing 420 is attached tobody portion 410 through connection joint 415, which is similar to that as was described in the embodiment of Figures 9-12. Slidably mounted onbody portion 410 isfinger ring assembly 430.Housing 420 includes afirst channel 422 and asecond channel 424. Disposed withinfirst channel 422 ispulley cable 423.Pulley cable 423 is rigidly attached, either directly or indirectly, tofinger ring assembly 430 such that it moves in conjunction withfinger ring assembly 430.Pulley cable 423 also includes astop member 423B which is disposed at a distal end ofpulley cable 423. - Disposed within
second channel 424 isneedle hub 462.Needle hub 462 includesengagement teeth 464 andinjection port 466. Rigidly attached toneedle hub 462 isinjection needle 460.Injection needle 460 is rigidly attached toneedle hub 462 at itsproximal end 460A and thedistal end 460B ofneedle 460 is disposed withinsheath 428, which is included at the distal end ofhousing 420 when it is in a non-operative position. Snare 450 extends proximally throughhousing 420 and is rigidly attached at itsproximal end 450A to slidingfinger ring assembly 430. Snare 450 passes throughhousing 420 inchannel 424 and thusneedle hub 462 includes aslot 462A to permitsnare 450 to pass throughchannel 424 without interfering with the movement ofneedle hub 462.Distal end 450B ofsnare 450 extends fromdistal end 428A ofsheath 428 when it is in an operative position. - Also included in
housing 420 isgear 470. In the embodiment of Figures 13-16,gear 470 is not configured as a circular gear as was the gear in the embodiment of Figures 9-12. However, the function ofgear 470 is similar to the function that was performed by the gear of Figures 9-12.Gear 470 is mounted onpin 421A that is disposed withinhousing 420. As such,gear 470 is able to rotate aboutpin 421A.Gear 470 includesengagement teeth 472 which cooperate withengagement teeth 464 that are included onneedle hub 462.Gear 470 also includes achannel 473 through which passespulley cable 423.Stop member 423B ofpulley cable 423 is disposed on the distal side of thechannel 473 that is withingear 470. As such,pulley cable 423 is not able to be retracted fully throughchannel 473.Pulley cable 423 will be prevented from being retracted completely throughgear 470 by the interaction ofstop member 423B with the structure ofgear 470 that defineschannel 473. - Also included on
gear 470 ispin 474. As will be explained,pin 474 cooperates with biasingmember 480. As will be further explained, biasingmember 480 cooperates withpin 474 and pin 421B, which is disposed withinhousing 420, tobias gear 470 into a first position whereneedle 460 is retracted withinsheath 428. - The operation of the tool actuator assembly for the embodiment of Figures 13-16 will now be described. Figures 13 and 14 show a configuration for
surgical instrument 400 where both theneedle 460 and thesnare 450 are fully retracted withinsheath 428. Figure 15 illustrates a configuration for thesurgical tool 400 whereinjection needle 460 has been extended fromsheath 428. - In order to extend
needle 460 out throughsheath 428, the operator slidesfinger ring assembly 430 proximally alongbody 410 to a position as shown in Fig. 15. Again, becausepulley cable 423 is rigidly attached tofinger ring assembly 430, either directly or indirectly, the proximal movement offinger ring assembly 430 alongbody 410 will also proximally movepulley cable 423. Whenpulley cable 423 is moved proximally,stop member 423B will engage withgear 470 and will pivotgear 470 in a counter-clockwise direction aboutpivot pin 421A. Becausestop member 423B is sized such that it can not pass completely throughchannel 473 that is formed withingear 470, the proximal motion ofpulley cable 423 will rotategear 470 counter-clockwise because of the interaction ofstop member 423B and the structure defining thechannel 473. The slidingfinger ring assembly 430 must be moved proximally alongbody 410 with sufficient force such thatgear 470 can be rotated counter-clockwise against the biasing force that is applied to gear 470 by biasingmember 480. Asgear 470 is rotated counter-clockwise aboutpivot pin 421A, engagingteeth 472 ofgear 470 will engage withteeth 464 ofneedle hub 462. Asgear 470 continues to rotate in a counter-clockwise direction the interaction ofgear teeth 472 withgear teeth 464 will moveneedle hub 462 in a distal direction withinchannel 424 ofhousing 420. Becauseneedle 460 is rigidly attached toneedle hub 462, the distal motion ofneedle hub 462 will also distally move thedistal end 460B ofneedle 460 withinsheath 428 and thus extenddistal end 460B ofneedle 460 beyonddistal end 428A ofsheath 428. - When the operator discontinues applying force to
finger ring assembly 430, the biasingmember 480 will act to rotategear 470 in a clockwise direction which in-turn will movehub 462 proximally withinchannel 424 inhousing 420. Thus, when the operator releases the force onfinger ring assembly 430, the injection needle is automatically retracted withinsheath 428 due to the biasingmember 480 acting upongear 470 to rotate the gear back in a clockwise direction. The clockwise rotation ofgear 470 proximally movesneedle hub 462 withinchannel 424 thus retractingneedle 460 withinsheath 428. - Figure 16 illustrates a configuration for
surgical instrument 400 wheresnare 450 has been exposed fromsheath 428. In order to extendsnare 450 fromsheath 428, the operator will slidably movefinger ring assembly 430 alongbody 410 in a distal direction. Figure 16 illustrates slidingfinger ring assembly 430 after it has been moved to thedistal end 410B ofbody 410. Whenfinger ring assembly 430 is moved distally alongbody 410,pulley cable 423 passes throughchannel 473 that is provided ingear 470.Stop member 423B passes through a distal portion ofchannel 422 inhousing 420 and the distal-most portion ofpulley cable 423 extends out through an aperture inhousing 420 that is located in the distal portion ofhousing 420. Thus, there is no interaction betweenpulley cable 423 andgear 470.Pulley cable 423 merely passes throughgear 470. Therefore, distal motion offinger ring assembly 430 does not result in any rotation ofgear 470. However, becausesnare 450 is rigidly attached to slidingfinger ring assembly 430, as slidingfinger ring assembly 430 is moved distally, the snare is also moved distally such that it is extended from thedistal end 428A ofsheath 428. Becauseslot 462A has been provided inneedle hub 462,snare 450 is able to pass by and throughneedle hub 462 without causing any movement ofneedle hub 462 withinchannel 424. As such, Figure 16 illustrates a configuration where adistal end 450B ofsnare 450, which is the working end ofsnare 450, has been extended fromsheath 428. - To retract
snare 450 back intosheath 428, the operator slidesfinger ring assembly 430 proximally alongbody 410 to the position illustrated in Figs. 13 and 14. - Figure 17 illustrates a fifth embodiment for a tool actuator assembly in accordance with the principles of the present invention. As can be seen,
surgical instrument 500 includes abody portion 510 and ahousing 520.Body portion 510 is a hollow cylindrical member that includes a firstsurgical tool 550 within it. For purposes of illustration, firstsurgical tool 550 will be discussed as a snare, however, firstsurgical tool 550 may be any of a variety of different surgical tools. Slidably disposed onbody 510 isfinger ring assembly 530.Finger ring assembly 530 is disposed onbody 510 such that it is able to move proximally and distally alongbody 510. Snare 550 is rigidly attached tofinger ring assembly 530 at a proximal end 550B ofsnare 550. Thus, as slidingfinger ring assembly 530 is moved alongbody 510,snare 550 is also moved withinbody 510. Attached to snare 550 iscoupler 552.Coupler 552 is rigidly attached to snare 550 and is disposed withinbody 510. A distal end 510A ofbody 510 includes a male threaded portion such that it is able to be joined tohousing 520 which includes an internally threaded female portion.Body 510 is joined tohousing 520 at connection joint 515. -
Housing 520 includes a second surgical tool assembly, which for purposes of illustration will be discussed asinjection needle 560. As can be seen in Figure 17,housing 520 includesneedle hub assembly 564 andneedle 560, which is connected toneedle hub assembly 564.Injection port 562 is provided onneedle hub assembly 564 in order to provide a fluid toinjection needle 560 for injection into the body of a patient, in accordance with well-known principles.Needle hub 564 is disposed withinchannel 522 which is formed withinhousing 520. Thus,needle hub 564 is able to move both distally and proximally withinhousing 520.Slot 524 is provided inhousing 520 to permitinjection port 562 to extend up throughhousing 520 andpermit injection port 562 to be able to be moved along withneedle hub 564 withinhousing 520. - Also provided within
housing 520 is biasingmember 525.Biasing member 525 is disposed in a distal end ofchannel 522 and biases needlehub 564 in a proximal direction withinhousing 520. Withneedle hub 564 biased proximally withinhousing 520,distal end 560A ofneedle 560 does not extend beyond a distal portion of a sheath (not shown in Figure 17) which is attached to the distal-most end 520A ofhousing 520 and which contains the distal portions of bothneedle 560 and snare 550 within it when both tools are in a retracted position. - Thus, as can be seen in Figure 17,
housing 520, which includes a needle assembly, provides the capability to reconfigure a known snare tool assembly such that it is able to have the additional functionality of an injection capability without requiring modification of the snare assembly itselfHousing 520 is merely attached to the snare instrument without requiring modification of the snare instrument. The operation of the multi-functionsurgical instrument 500 will be explained below. - In order to extend
snare 550 from a sheath that is attached tohousing 520 and which enclosessnare 550, the operator would slidefinger ring assembly 530 in a distal direction alongbody 510. Distal movement offinger ring assembly 530 will movedistal end 550A distally within the sheath such that thedistal end 550A ofsnare 550 will extend from the distal end of the sheath. Thus, distal motion offinger ring assembly 530 extendssnare 550 from the sheath of thesurgical instrument 500. Aslot 566 is provided inneedle hub 564 in order to permitsnare 550 to move withinhousing 520 without being impeded byneedle hub 564. As will be explained, the distal movement ofsnare 550 will also extendneedle 560 from the sheath. Thus, bothsnare 550 andneedle 560 are extended from the sheath ofsurgical instrument 500 by the movement offinger ring assembly 530 distally alongbody 510. - As
snare 550 is moved distally withinbody 510,coupler 552, which is rigidly attached to snare 550 withinbody 510, also is moved distally withinbody 510. Assnare 550 continues to move distally withinbody 510,coupler 552 will exit through an aperture included in the distal end 510A ofbody 510. Ascoupler 552 exits the distal end 510A ofbody 510, it will enter the proximal end ofhousing 520. Ascoupler 552 enters the proximal end ofhousing 520, it will engage with theproximal structure 568 ofneedle hub 564. Becausecoupler 552 is formed such that it is larger in size thanchannel 566 that has been formed inneedle hub 564, it will not merely pass byhub 564 throughchannel 566, but rather will than engage thestructure 568 at the proximal end ofneedle hub 564. The engagement betweencoupler 552 andneedle hub 564 will moveneedle hub 564 distally withinhousing 520 ascoupler 552 continues its distal movement along withsnare 550. Sufficient force must be applied to snare 550, and thuscoupler 552, such that it can moveneedle hub 564 distally withinhousing 520 against the biasing force that is applied by biasingmember 525. Asneedle hub 564 moves distally withinhousing 520,needle 560, which is attached toneedle hub 564, also moves distally with respect tohousing 520. This distal movement ofneedle 560 will cause thedistal end 560A ofneedle 560 to extend from a distal end of the sheath that encloses the needle. Thus, in this manner, the distal motion ofsnare 550 also causes distal motion ofneedle 560, resulting in extension of bothsnare 550 andneedle 560 fromsurgical instrument 500. - In order to retract
snare 550 andneedle 560 back into the sheath of thesurgical instrument 500, a user would movefinger ring assembly 530 in a proximal direction alongbody 510. Proximal motion offinger ring assembly 530 alongbody 510 will also movesnare 550 in a proximal direction with respect tobody 510. Continued proximal motion ofsnare 550 will result indistal end 550A ofsnare 550 being retracted within the sheath of thesurgical instrument 500. Assnare 550 is moved proximally withinsurgical instrument 500, forward pressure will no longer be applied toneedle hub 564 bycoupler 552. As the forward pressure is removed fromneedle hub 564, biasingmember 525 will forceneedle hub 564 to move proximally withinchannel 522 inhousing 520. The proximal movement ofneedle hub 564 withinchannel 522 under the biasing force of biasingmember 525 will retract thedistal end 560A ofneedle 560 within the sheath of thesurgical instrument 500. - Figures 18-24 illustrate a sixth embodiment for a tool actuator assembly in accordance with the present invention. As can be seen in Figure 18,
surgical instrument 600 includes a first tool 650 (shown in phantom), which is disclosed as an injection needle, and a second tool 660 (also shown in phantom), which is disclosed as a snare. Again, as with the other embodiments that have been previously discussed, the first and second tools can be any of a variety of tools and the present invention as embodied in Figures 18-24 is not limited to an embodiment where the surgical tools are a needle and a snare. As can be seen in Figure 18,surgical instrument 600 includes abody portion 610, afinger ring assembly 630 slidably mounted onbody 610 for movement in both a proximal and distal direction onbody 610, atool actuating member 620, and aninjection adaptor port 670.Second tool 660 is attached tofinger ring assembly 630 and thus its movement is controlled byfinger ring assembly 630. Distal movement offinger ring assembly 630 towarddistal end 610A ofbody 610 will result in thedistal end 660A, which would include a snare loop (not shown), ofsecond tool 660 being extended fromdistal end 610A ofbody 610. Likewise, proximal motion offinger ring assembly 630 toward proximal end 610B ofbody 610 will retractdistal end 660A ofsecond tool 660 withindistal end 610A ofbody 610. - The actuation of
needle 650 is controlled by interaction offinger ring assembly 630 andtool actuating member 620, as will be explained further.Tool actuating member 620 is pivotally attached tobody 610 at the proximal end 610B ofbody 610. Proximal end 610B ofbody 610 includes apivot pin 615 that is rigidly attached tobody 610.Tool actuating member 620 is pivotally mounted onpivot pin 615.Needle 650 is disposed withinbody 610 ofsurgical instrument 600 and a proximal portion 650B ofneedle 650 is rigidly attached totool actuating member 620.Tool actuating member 620 includes aneedle attachment portion 622. Needle proximal portion 650B is attached toneedle attachment portion 622 oftool actuating member 620. - In further describing
tool actuating member 620, Figure 19 illustrates the tool actuating member. As can be seen,tool actuating member 620 includes aneedle attachment portion 622 and anengagement portion 626.Needle attachment portion 622 is comprised of afirst arm member 623 and asecond arm member 624. Aslot 625 is defined byfirst arm 623 andsecond arm 624. Included inarm 623 isaperture 623A and included inarm 624 isaperture 624A. An attachment pin 629 (visible in Figure 21 but not shown in Figure 19) is utilized to attachneedle 650 to actuatingmember 620. Needle proximal portion 650B is received withinslot 625. Needle proximal portion 650B includes an aperture that also receivesattachment pin 629 within it. The aperture that is defined by needle proximal portion 650B is aligned withaperture needle attachment portion 622.Attachment pin 629 is positioned throughaperture 623A, the aperture defined by needle proximal end 650B, andaperture 624A. Thus,needle 650 is attached toneedle attachment portion 622. -
Engagement portion 626 oftool actuating member 620 defines aperture 626A. Aperture 626A receivespivot pin 615, which is attached tobody 610, within it. Thus,tool actuating member 620 is able to be pivotally mounted tobody 610 throughpivot pin 615 being received within aperture 626A. As can be seen in Figure 19, the longitudinal axis X1 ofneedle attachment portion 622 is off-set from the longitudinal axis X2 ofengagement portion 626. Additionally, the length L1 ofneedle attachment portion 622 is greater than the length L2 ofengagement portion 626. The purposes of the axis off-set and the length difference betweenneedle attachment portion 622 andengagement portion 626 will become clear upon describing the operation oftool actuating member 620. - The proximal end 610B of
body 610 ofsurgical instrument 600 is illustrated in Figure 20. As can be seen, the proximal end 610B ofbody 610 includespivot pin 615. As was mentioned previously,pivot pin 615 is received within aperture 626A oftool actuating member 620 to pivotally mount actuatingmember 620 ontobody 610. Proximal end 610B ofbody 610 also includesthumb ring 617. - In describing the operation of
tool actuating member 620, Figure 18 illustratestool actuating member 620 in a first position wheredistal end 650A ofneedle 650 is retracted withinsurgical instrument 600. A more detailed view of thetool actuating member 620 in this first position can be seen in Figure 21. As can be seen in Figure 21,needle attachment portion 622 is located proximally with respect tobody 610. Thus, becauseneedle 650 is attached to actuatingmember 620 onneedle attachment portion 622,needle 650 has been moved proximally with respect tobody 610 ofsurgical instrument 600. As can be further seen in Figure 21,finger ring assembly 630 is positioned adjacent toengagement portion 626 oftool actuating member 620, but has not as of yet exerted any force uponengagement portion 626. - Figure 22 illustrates actuating
member 620 after it has been pivoted to its second position, which in-turn has extendeddistal end 650A ofneedle 650 fromdistal end 610A ofbody 610. A more detailed view for the positioning of actuatingmember 620 in its second position whereneedle 650 has been extended fromsurgical instrument 600 can be seen in Figure 23. As seen in Figure 23,finger ring assembly 630 has been moved proximally alongbody 610 such that the structure offinger ring assembly 630 has engaged withengagement portion 626 of actuatingmember 620. Asfinger ring assembly 630 continues its movement proximally alongbody 610, the force that is applied toengagement portion 626 of actuatingmember 620causes actuating member 620 to pivot counter-clockwise aboutpivot pin 615. This pivotal motion of actuatingmember 620 onpivot pin 615 causesneedle attachment portion 622 to move distally with respect tobody 610. Distal motion ofneedle attachment portion 622 results in distal motion ofneedle 650 withinbody 610. The rotation of actuatingmember 620 aboutpivot pin 615 is sufficient to distallymove attachment portion 622 such thatdistal end 650A ofneedle 650 is extended beyonddistal portion 610A ofbody 610. Thus, thedistal end 650A ofneedle 650 is exposed fromsurgical instrument 600 such that it may inject fluid into the body of a patient. - As was explained earlier, the longitudinal axis of
attachment portion 622 is off-set from the longitudinal axis ofengagement portion 626. Additionally, the length ofneedle attachment portion 622 is greater than the length ofengagement portion 626. These differences between the two portions of actuatingmember 620 results in a mechanical advantage for movingneedle 650 distally withinbody 610 by pivoting actuatingmember 620. In other words, proximal movement ofengagement portion 626 of actuatingmember 620, caused by counter-clockwise rotation of the actuatingmember 620 through interaction with a proximally moving slidingfinger ring assembly 630, will result in a greater length of distal movement ofneedle attachment portion 622 oftool actuating member 620. Thus, a relatively small movement offinger ring assembly 630 in a proximal direction will result in a significantly greater movement ofneedle 650 in a distal direction. - Once the needle has been utilized to injection fluid into a patient,
surgical instrument 600 can be removed from the patient andneedle 650 can be retracted withinsurgical instrument 600 through manual rotation of actuatingmember 620 by the user of the instrument. Retraction of theneedle 650 withinsurgical instrument 600 is not as critical an operation as extension of the needle because the process of extending the needle occurs while the instrument is within a patient and thus efficient movement of the needle while the instrument is in the patient is important. Conversely, after the needle has been utilized to inject fluid into the patient, the surgical instrument can be removed from the patient and the needle can be manually retracted into the instrument by the surgeon after the procedure has been performed. - Figure 24 illustrates an
injection adaptor port 670 that can be utilized with the embodiment for the surgical instrument as disclosed in Figures 18-24.Injection adaptor port 670 includes anattachment portion 672 that is utilized to attach theinjection adaptor port 670 tobody 610 ofsurgical instrument 600.Injection adaptor port 670 may include internal threading atattachment portion 672 that can cooperate with an externally threaded male portion included at the distal end ofbody 610 in order to attachinjection adaptor port 670 tobody 610. Distal end 674 ofinjection adaptor port 670 includes an aperture such thatdistal end 650A ofinjection needle 650 is able to extend out through theinjector adaptor port 670.Injector adaptor port 670 defines aslot 676 that extends fromattachment portion 672 to distal end 674. Received withinslot 676 isinjection port 655 that is included at thedistal end 650A ofinjection needle 650. - Figures 25-41 illustrate a seventh embodiment for a tool actuator assembly in accordance with the present invention. As can be seen in Figures 25 and 26,
surgical instrument 700 is comprised of abody portion 710, a slidingfinger ring assembly 730, a tool selection and lockingswitch 760, and first andsecond instrument hubs first instrument hub 740 and a second surgical tool (also not shown in Figures 25 and 26) would be associated withsecond instrument hub 750. As will be explained, a surgeon utilizingsurgical instrument 700 would select between using the first surgical tool and the second surgical tool by selectively engaging either thefirst instrument hub 740 or thesecond instrument hub 750 with tool selection and lockingswitch 760. The embodiment of Figures 25-41 for thesurgical instrument 700 is not limited to any particular tools that may be incorporated into the instrument. However, for purposes of illustration, it will be described thatfirst instrument hub 740 is associated with an injection needle andsecond instrument 750 is associated with a snare device. - In further describing
surgical instrument 700, as can be seen in Figures 25 and 26,surgical instrument 700 is comprised of abody portion 710.Body portion 710 is comprised of acentral hub 713, anouter frame member 712, and anouter frame member 714.Central hub 713 andouter frame member 712 define afirst channel 712A andcentral hub 713 andouter frame member 714 define asecond channel 714A. Located at adistal end 710A ofbody portion 710 issheath attachment portion 716.Sheath attachment portion 716 provides for attachment of a catheter or similar structure tobody portion 710 through which the surgical tools that are associated with thesurgical instrument 700 would extend frombody portion 710. - Sliding
finger ring assembly 730 is slidably mounted ontobody portion 710. Slidingfinger ring assembly 730 is operably associated with tool selection and lockingswitch 760 and the first andsecond instrument hubs First instrument hub 740 is mounted for slidable motion with respect tobody portion 710 withinfirst channel 712A andsecond instrument hub 750 is likewise mounted for slidable motion with respect tobody portion 710 withinsecond channel 714A. Tool selection and lockingswitch 760 is comprised of atop switching member 770 and a bottom switching member 780 (not visible in Figures 25 and 26) and operably interacts withfirst instrument hub 740 andsecond instrument 750 to engage one of the instrument hubs with top switchingmember 770 for use of the hub, and consequently the surgical tool associated with that hub, and lock-out from use the other of the instrument hubs withbottom switching member 780 and the tool associated with that instrument hub. The operation of tool selection and lockingswitch 760 and its interaction with the first andsecond instrument hubs switch 760 in a first position wherefirst instrument hub 740 has been engaged by top switchingmember 770 for use of the surgical tool that is associated with thefirst instrument hub 740 and whereinsecond instrument hub 750 has been engaged bybottom switching member 780 in order to lock-out thesecond instrument hub 750 from use by the user of thesurgical instrument 700. - Figures 27 and 28 illustrate the
top switching member 770 of tool selection and lockingswitch 760 and Figures 29 and 30 illustrate thebottom switching member 780 of the tool selection and lockingswitch 760. In first describingtop switching member 770, Figure 27 is a side view oftop switching member 770 and Figure 28 is a bottom view of thetop switching member 770. As can be seen, top switchingmember 770 is comprised of a flat circularplanar member 772. Attached to the top of circularplanar member 772, such that it extends above slidingfinger ring assembly 730 whentop switching member 770 is mounted within slidingfinger ring assembly 730, isfinger grip 774. Attached to a bottom portion ofplanar member 772 are instrumenthub actuating member 775 and bottom switchmember engagement tab 776. Instrumenthub actuating member 775 and bottom switchmember engagement tab 776 are disposed on the bottom side ofplanar member 772 such that they extend within slidingfinger ring assembly 730 and withinbody portion 710 to engage with the first andsecond instrument hubs bottom switching member 780, respectively. Instrumenthub actuating member 775 is an elongated cylindrical member and extends fromplanar member 772. Bottom switchmember engagement tab 776 is also a cylindrical member that extends down fromplanar member 772, however, bottom switchmember engagement tab 776 also includes a v-shapedengagement portion 777, which can be seen in Figure 28, the purpose of which is to engage withbottom switching member 780. As will be further explained, instrumenthub actuating member 775 engages withinstrument hubs member engagement tab 776 engages withbottom switching member 780. - Figures 29 and 30 illustrate
bottom switching member 780. Figure 29 is a perspective view ofbottom switching member 780 and Figure 30 is a top view ofbottom switching member 780. As can be seen,bottom switching member 780 is comprised of acircular base 782, an instrumenthub locking member 784, and a top switchmember engagement tab 786. Top switchmember engagement tab 786 defines a v-shapedgrove 786B which is formed to receive the v-shape engagement portion 777 oftop switching member 770 within it.Bottom switching member 780 is disposed withinbody portion 710 for rotational motion withinbody portion 710. As will be further explained, the purpose of instrumenthub locking member 784 is to engage withinstrument hubs member engagement tab 786 is designed to engage with top switchingmember 770 such that astop switching member 770 is rotated in order to engage one of the first orsecond instrument hubs hub actuating member 775 to select for use the engaged instrument hub, this rotational movement oftop switching member 770 to engage an instrument hub for use also rotatesbottom switching member 780 so that instrumenthub locking member 784 ofbottom switching member 780 engages the other of the instrument hubs that is not selected for use to lock-out from operation that instrument hub. - Figure 31 illustrates the
top switching member 770 andbottom switching member 780 of the tool selection and lockingswitch 760 as they would be positioned with respect to each other withinbody portion 710 and sliding finger ring assembly 730 (both not shown) withinsurgical instrument 700. As can be seen, bottom switchmember engagement tab 776 oftop switching member 770 has engaged top switchmember engagement tab 786 ofbottom switching member 780 by utilizing the complementary v-shaped engagement portions of thetop switching member 770 and thebottom switching member 780, as described previously. Thus, as can be understood, rotational movement oftop switching member 770 will also cause rotational movement ofbottom switching member 780 due to the interaction of the bottom switchmember engagement tab 776 and the top switchmember engagement tab 786. - Figures 32-34 illustrate the sliding
finger ring assembly 730. Figure 32 is a top view of the slidingfinger ring assembly 730, Figure 33 is a rear view of thefinger ring assembly 730, and Figure 34 is a bottom view of the slidingfinger ring assembly 730. As can be seen, slidingfinger ring assembly 730 is comprised offinger rings body portion 732.Body portion 732 is a hollow structure that is defined bytop body portion 732A and bottom body portion 732B. As such,body portion 710 of surgical-instrument 700 is received within surgicalinstrument body aperture 737, which is defined bytop body portion 732A and bottom body portion 732B offinger ring assembly 730, as seen in Figure 33. Thus,finger ring assembly 730 can be slidably moved alongbody portion 710 ofsurgical instrument 700. -
Top body portion 732A offinger ring assembly 730 defines top switchmember receiving aperture 733, instrument hub actuatingmember aperture 734, instrument hub lockingmember aperture 735, and instrumenthub extension aperture 736.Planar member 772 oftop switching member 770 is received within top switchmember receiving aperture 733 infinger ring assembly 730. As such, top switchingmember 770 is mounted for rotational motion within slidingfinger ring assembly 730. When top switchingmember 770 is positioned within slidingfinger ring assembly 730 for rotational motion within the sliding finger ring assembly, the bottom switchmember engagement tab 776 oftop switching member 770 extends through instrument hub lockingmember aperture 735 defined by slidingfinger ring assembly 730 and instrumenthub actuating member 775 oftop switching member 770 extends through instrument hub actuatingmember aperture 734 which is also defined by slidingfinger ring assembly 730. Thus, as mentioned previously, top switchingmember 770 is mounted for rotational motion within slidingfinger ring assembly 730 and the rotational movement oftop switching member 770 within slidingfinger ring assembly 730 is limited by the motion of instrumenthub actuating member 775 within instrument hub actuatingmember aperture 734. - Thus, in referring back to Figure 31, it can be seen that the union between bottom switch
member engagement tab 776 oftop switching member 770 and top switchmember engagement tab 786 ofbottom switching member 780 extends through the instrument hub lockingmember aperture 735 within slidingfinger ring assembly 730. Also, it can be seen that instrumenthub actuating member 775 oftop switching member 770 would be received within instrument hub actuatingmember aperture 734 in slidingfinger ring assembly 730. - Instrument
hub extension aperture 736 in slidingfinger ring assembly 730 extends completely through thetop body portion 732A in slidingfinger ring assembly 730 and is provided to accommodate any extensions frominstrument hub 740 andinstrument hub 750 that may be associated with the surgical tools that are carried by the instrument hubs. For example, as can be seen in Figures 25 and 26,first instrument hub 740 includes afluid port 742 that would be utilized to provide fluid through the instrument hub to an injection needle that would be associated with the instrument hub. Similarly,second instrument hub 750 includes anelectrocautery insert 752 that would be associated with a snare tool that is carried by thesecond instrument hub 750. Thus, slidingfinger ring assembly 730 is provided with instrumenthub extension aperture 736 so that any extensions from the instrument hubs may be received within the slidingfinger ring assembly 730. - Figures 35 to 38 illustrate
first instrument hub 740. Sincesecond instrument hub 750 is formed similar tofirst instrument hub 740, with the exception that any extensions from the hubs may be differently formed to accommodate the particular surgical tool that is associated with the instrument hub, a detailed description will only be provided offirst instrument hub 740.First instrument hub 740 is comprised of atop portion 744 and abottom portion 746. Attached totop portion 744 isfluid port 742 that would be utilized iffirst instrument hub 740 was utilized in combination with an injection needle, as described previously.Top portion 744 defines an instrumenthub actuating slot 744A. Instrumenthub actuating slot 744A is designed to receive in it the instrumenthub actuating member 775 oftop switching member 770. When instrumenthub actuating member 775 is rotated to be received within instrument hub actuating slot 774A offirst instrument hub 740,first instrument hub 740 is mated with top switchingmember 770 and thus, movement of slidingfinger ring assembly 730 in a distal direction alongbody portion 710 ofsurgical instrument 700 will also movefirst instrument hub 740 distally alongbody portion 710. Thus, the surgical tool that is associated with thefirst instrument hub 740 will also be moved distally alongbody portion 710 ofsurgical instrument 700 such that a distal end of the surgical tool would extend from a sheath that is attached tosheath attachment portion 716 ofsurgical instrument 700 so that the surgical tool could be utilized by the surgeon that is utilizing theinstrument 700. - In further describing
instrument hub 740,instrument hub 740 includesbottom portion 746.Bottom portion 746 defines an instrumenthub locking slot 746A. Instrumenthub locking member 784 ofbottom switching member 780 is received within instrumenthub locking slot 746A ofinstrument hub 740. Thus, when instrumenthub actuating member 775 oftool switching member 770 engages with instrumenthub actuating slot 744A offirst instrument hub 740, the instrumenthub locking member 784 engages with the instrument hub locking slot of the other instrument hub of thesurgical instrument 700. Thus, through rotation oftop switching member 770, one of the instrument hubs is engaged by top switchingmember 770 for use and the other of the instrument hubs is locked out from operation bybottom switching member 780. The v-grove arrangement between top switchingmember 770 andbottom switching member 780, as described previously, allows for rotation ofbottom switching member 780 whentop switching member 770 is rotated by a user of the surgical instrument. - Also associated with
first instrument hub 740 isbody engagement portion 748.Body engagement portion 748 includesretention rails 748A which extend outwardly frombody engagement portion 748 and serve to guide and retainfirst instrument hub 740 withinfirst channel 712A that is defined withinbody portion 710 ofsurgical instrument 700. - Figures 39 and 40 illustrate the tool selection and locking
switch 760 as it is used in combination withfirst instrument hub 740 andsecond instrument hub 750. For purposes of illustration, the tool selection and lockingswitch 760 and thefirst instrument hub 740 andsecond instrument hub 750 are shown without the slidingfinger ring assembly 730. Top switchingmember 770 has been rotated so that instrument hub actuating member 775 (not visible in Figure 39) is received within the instrumenthub actuating slot 744A offirst instrument hub 740. Whereas it can not be seen in Figures 39 and 40, it can be understood from the previous discussion that astop switching member 770 is rotated to engage withfirst instrument hub 740,bottom switching member 780 has also been rotated such that it has now engaged with the locking slot ofsecond instrument hub 750 in order to lock-out from operationsecond instrument hub 750. - Figure 41 is a cross sectional view of
surgical instrument 700 taken along lines 41-41 of Figure 26. As can be seen,first instrument hub 740 is disposed withinfirst channel 712A andsecond instrument hub 750 is disposed withinsecond channel 714A and top switchingmember 770 is disposed within slidingfinger ring assembly 730. - In operation, a surgeon that desires to utilize a first surgical tool that is associated with
first instrument hub 740 would rotatetop switching member 770 such thattop switching member 770 engages withfirst instrument hub 740. The rotation oftop switching member 770 will also rotatebottom switching member 780 such that it engages withsecond instrument hub 750 in order to lock-out from operation the second surgical tool that is associated withsecond instrument hub 750. When top switchingmember 770 has been rotated to a first position as illustrated in Figure 25 where thetop switching member 770 has engaged withfirst instrument hub 740, movement of slidingfinger ring assembly 730 in a distal direction alongbody portion 710 ofsurgical instrument 700 will also slidefirst instrument hub 740 distally alongbody portion 710. Thus, the surgical tool that is associated withfirst instrument hub 740 can be extended fromsurgical instrument 700. Because the slidingfinger ring assembly 730, thetop switching member 770, andfirst instrument hub 740 are all structurally mated, movement of slidingfinger ring assembly 730 will causefirst instrument hub 740 to move along with slidingfinger ring assembly 730. Sincebottom switching member 780 is rotatably mounted tobody portion 710 ofsurgical instrument 700, its engagement withsecond instrument hub 750 will prevent movement ofsecond instrument hub 750 and thus, lock-out from operation the surgical tool that is associated withsecond instrument hub 750. - If a surgeon desires to utilize the second surgical tool that is associated with the
second instrument hub 750, the surgeon would rotatetop switching member 770 such that it would engage withsecond instrument hub 750. The rotation oftop switching member 770 to engage withsecond instrument hub 750 would also rotatebottom switching member 780 such that it would now engage withfirst instrument hub 740. Thus, movement of slidingfinger ring assembly 730 would now cause movement ofsecond instrument hub 750 along with the slidingfinger ring assembly 730. Additionally,bottom switching member 780, which is now engaged withfirst instrument hub 740, would causefirst instrument hub 740 to be locked out from operation. - Thus, as described, tool selection and locking
switch 760 provides for engaging a particular instrument hub for operation of the tool associated with the instrument hub and locking out a second surgical tool from operation that is associated with a second instrument hub. In this manner, a user of thesurgical instrument 700 can select a particular tool for use and prevent a second tool contained within the instrument from deployment from the tool. - Figures 42-50 illustrate an eighth embodiment for a tool actuator assembly in accordance with the present invention. As can be seen in Figures 42 and 45,
surgical instrument 800 is comprised of abody portion 810, a slidablefinger ring assembly 830, afirst instrument hub 840, asecond instrument hub 850, and first andsecond actuator buttons First instrument hub 840 is associated with a first surgical tool (not shown) andsecond instrument hub 850 is associated with a second surgical tool (also not shown). The first and second tools could be any of a variety of tools and the present invention is not limited to any particular embodiment for the surgical tools that may be utilized insurgical instrument 800. As will be further explained later in this specification, the first surgical tool would be extended from, and retracted into,surgical instrument 800 by slidinginstrument hub 840 alongsurgical instrument 800 and the second surgical tool would also be extended from, and retracted into,surgical instrument 800 by slidingsecond instrument hub 850 withinsurgical instrument 800. As will also be further explained,first actuator button 860 andsecond actuator button 862 are utilized to select which instrument hub is engaged by slidingfinger ring assembly 830 so that the surgical tool associated with the selected instrument hub is able to be extended from, and retracted into, thesurgical instrument 800. - In further describing
surgical instrument 800,body portion 810 is comprised ofouter frame member 812 andouter frame member 814.Central hub 813 is disposed between outer frommember 812 andouter frame member 814. As such,central hub 813 andouter frame member 812 define afirst channel 815 andcentral hub 813 andouter frame member 814 define asecond channel 816. Located withinouter frame member 812 is aslot 812A that extends generally along the entire length ofbody portion 810. Similarly,outer frame member 814 also includesslot 814A. As will be further explained later in this specification,first actuator button 860 extends throughslot 812A andsecond actuator button 862 extends through 814A. -
Distal end 810A ofbody portion 810 includessheath attachment portion 816.Sheath attachment portion 816 is provided so that a sheath can be connected tosurgical instrument 800 for insertion into the body of a patient. An aperture (not shown in Figure 42) extends throughdistal end 810A ofbody 810 such that the first surgical tool and the second surgical tool may extend fromsurgical instrument 800. - Sliding
finger ring assembly 830 is disposed onbody portion 810 for slidable motion with respect tobody portion 810. Slidingfinger ring assembly 830 includes afirst finger ring 831A and asecond finger ring 831B.Body portion 832 offinger ring assembly 830 is a hollow, cylindrical member that receivesbody portion 810 ofsurgical instrument 800 within it. Disposed on either side ofbody portion 832 of slidingfinger ring assembly 830 areactuator button housings actuator button housing 834 housesfirst actuator button 860 within it and secondactuator button housing 835 housessecond actuator button 862 within it. As can be seen in Figures 42 and 47, firstactuator button housing 834 includes first actuatorbutton guide pin 834A within it and secondactuator button housing 835 contains second actuatorbutton guide pin 835A within it. First actuatorbutton guide pin 834A is disposed withinguide slot 860A offirst actuator button 860 and second actuatorbutton guide pin 835A is disposed withinguide slot 862A ofsecond actuator button 862. The actuator button guide pins in each actuator button housing are rigidly attached to the housing. As such, the actuator button guide pins, in conjunction with the guide slots in each actuator button, serve to guide and limit the motion of theactuator buttons actuator button housings - Figure 43 illustrates the assembled configuration of first and
second actuator buttons 860, 862 (not shown), respectively, slidingfinger ring assembly 830, and first andsecond instrument hubs body portion 810 ofsurgical instrument 800. In further describing the interaction offirst instrument hub 840,second instrument hub 850,finger ring assembly 830, andfirst actuator button 860 andsecond actuator button 862,first instrument hub 840 andsecond instrument hub 850 will be more fully described. - As can be seen in Figure 43,
first instrument hub 840 is comprised of first instrumenthub extension member 841, firsttool attachment member 842, and firsthub engagement member 844. Firsttool attachment member 842 is a cylindrical body and serves as the attachment mechanism for a first surgical tool that would be incorporated intosurgical instrument 800. The surgical tool would attach to the distal end 842A of the firsttool attachment member 842. First instrumenthub extension member 841 can be integrally formed with firsttool attachment member 842.First instrument hub 840 also includes firsthub engagement member 844. Firsthub engagement member 844 defines anengagement slot 845 which includes an engagement portion 845A and aopen portion 845B. Firsthub engagement member 844 also includes attachment slot 846 (visible in Figures 44 and 47) within it.Attachment slot 846 receives hub attachment pin 847 (also visible in Figure 47) within it. Hub attachment pin 847 extends up from firsttool attachment member 842 and throughattachment slot 846. As such, firsthub engagement member 844 is slidably mounted onto firsttool attachment member 842 and is movable with respect to firsttool attachment member 842 in a direction perpendicular to the longitudinal axis of the firsttool attachment member 842, i.e., in a direction transverse to the direction of movement offirst instrument hub 840 withinbody 810. Extending downward frombody portion 832 of slidingfinger ring assembly 830 is first fingerring engagement pin 836. First fingerring engagement pin 836 is rigidly attached to slidingfinger ring assembly 830 and is received withinengagement slot 845 of the firsthub engagement member 844. - Similarly,
second instrument hub 850 also includes a secondtool attachment member 852 which would have attached to itsdistal end 852A a second surgical tool. Formed with secondtool attachment member 852 is second instrumenthub extension member 851. Also, secondhub engagement member 854, which definesengagement slot 855 andattachment slot 856 is slidably mounted onto secondtool attachment member 852.Engagement slot 855 also includes an engagement portion 855A and anopen portion 855B. Additionally, ahub attachment pin 857 is disposed on secondtool attachment member 852 and is received withinattachment slot 856. A second fingerring engagement pin 837 is rigidly attached tobody portion 832 of slidingfinger ring assembly 830 and extends downward frombody portion 832. Second fingerring engagement pin 837 is received withinengagement slot 855 of secondhub engagement member 854. - Figure 44 illustrates the configuration of first and
second actuator buttons hub engagement member 844 and secondhub engagement member 854. For purposes of clarity,finger ring assembly 830 is not shown in Figure 44, however, the first fingerring engagement pin 836 and second fingerring engagement pin 837 and the first actuatorbutton guide pin 834A and second actuatorbutton guide pin 835A, which are all rigidly attached to the slidingfinger ring assembly 830, are shown so that the structural arrangement between the pins and the associated members can be clearly seen. As can be seen in Figure 44,body portion 810 ofsurgical instrument 800 includes anaperture 811 through it so that thehub engagement members body portion 810 and throughbody portion 810, as will be described below. - Figures 46-50 illustrate various cross-sectional views of
surgical instrument 800 as taken along Figure 45. - In describing the operation of the tool actuator assembly in accordance with the embodiment of Figures 42-50, reference will be made particularly to Figure 43. As can be understood in Figure 43, second actuator button 862 (not visible) has been depressed so that it extends entirely within second
actuator button housing 835. Motion ofsecond actuator button 862 will be restrained against further motion withinhousing 835 due to engagement of second actuatorbutton guide pin 835A withinguide slot 862A ofsecond actuator button 862. Whensecond actuator 862 is depressed into secondactuator button housing 835,second actuator button 862 in-turn moves secondhub engagement member 854 in a direction towards the center ofsurgical instrument 800. As secondhub engagement member 854 is moved in this direction, second fingerring engagement pin 837 will be positioned withinengagement slot 855 such that second fingerring engagement pin 837 is disposed in theopen portion 855B ofengagement slot 855. - The movement of
second actuator button 862 and secondhub engagement member 854 also forces firsthub engagement member 844 andfirst actuator button 860 in the same direction. This movement of firsthub engagement member 844 causes first fingerring engagement pin 836 to be positioned within engagement portion 845A ofengagement slot 845. Further, in this position, firsthub engagement member 844 extends completely out ofaperture 811 that is included inbody portion 810. Thus, firsthub engagement member 844 is not constrained against distal movement alongbody portion 810 bybody portion 810. The movement of firsthub engagement member 844 forcesfirst actuator button 860 to extend out from firstactuator button housing 834. - Thus, with
second actuator button 862 in this position where it is fully inserted within secondactuator button housing 835,finger ring assembly 830, through first finger ringengagement ring pin 836, which is now engaged with firsthub engagement member 844, will allowfirst instrument hub 840 to be moved distally alongbody portion 810 ofsurgical instrument 800 when slidingfinger ring assembly 830 is moved distally alongbody portion 810. Because second fingerring engagement pin 837 is now received withinopen portion 855B ofengagement slot 855 of secondhub engagement member 854, as thefinger ring assembly 830 is moved distally alongbody portion 810, the second fingerring engagement pin 837 will be moved out of secondhub engagement member 854, thus not engaging secondhub engagement member 854. The second instrument hub will then not be selected for movement along with slidingfinger ring assembly 830. Because secondhub engagement member 854 will be received withinaperture 811 inbody portion 810, thesecond instrument hub 850 will, in effect, be locked from distal movement alongsurgical instrument 800. - In order to select the
second instrument hub 850 for movement along with slidingfinger ring assembly 830, the same procedure as outlined above is utilized. As such, to selectsecond instrument hub 850, and thus, a second surgical tool that is associated with thesecond instrument hub 850, for activation with the slidingfinger ring assembly 830, the operator would depressfirst actuator button 860 so that it is fully received within firstactuator button housing 834. The movement offirst actuator button 860 in this direction would result in the first fingerring engagement pin 836 being received within theopen portion 845B ofengagement slot 845 in firsthub engagement member 844. Additionally, this movement offirst actuator button 860 would force second fingerring engagement pin 837 to be received within the engagement portion 855A ofengagement slot 855 and secondhub engagement member 854. Thus, as slidingfinger ring assembly 830 is moved distally alongbody portion 810 ofsurgical instrument 800,second instrument hub 850 would also be moved distally alongbody portion 810 due to the interaction between second fingerring engagement pin 837 and secondhub engagement member 854. - Thus, the actuator assembly as described in Figures 42-50 provide for selectively engaging a surgical tool for use within
surgical instrument 800. The surgical tool that is not selected for use is, in effect, locked into position within thebody 810 of thesurgical instrument 800 so that it may not be deployed from theinstrument 800. - Figures 51-75 illustrate a ninth embodiment for the tool actuator assembly of the present invention. As will be further described, and as will become clear, the
surgical instrument 900 of Figures 51-75 is similar to the surgical instruments disclosed in the previous two embodiments in that it contains two instrument hubs that are engageable by an actuator. However, the configuration of the actuator assembly and hub assemblies are different in the present embodiment from the previous embodiments discussed. - Figures 51 and 52 illustrate
surgical instrument 900. As can be seen,surgical instrument 900 is comprised of abody portion 910, aguide bar 920, a slidingfinger ring assembly 930, afirst instrument hub 940, a second instrument hub 950 (not visible in Figure 51), and ahub actuator 960. Each of these components that are associated withsurgical instrument 900 will be discussed in further detail below. As described previously for embodiments 7 and 8,surgical instrument 900 also includes a first surgical tool and a second surgical tool (not shown in Figures 51-75). As such, the first surgical tool would be associated withfirst instrument hub 940 and the second surgical tool would be associated withsecond instrument hub 950. The present invention is capable of being utilized with any of a variety of devices for the first surgical tool and the second surgical tool and the present invention is not limited to any particular embodiments for the surgical tools. As will be further explained, the first and second surgical tools are capable of being extended from, and retracted into,surgical instrument 900 by movement offirst instrument hub 940 andsecond instrument 950, respectively, alongbody portion 910 ofsurgical instrument 900. - Attached at
distal end 910A ofbody portion 910 is sheathstress relief member 980. A sheath can be attached to sheathstress relief member 980 for insertion into the body of a patient and the first and second surgical tools included insurgical instrument 900 would extend through the sheath for insertion into the body of the patient. - Figures 53-58 illustrate the
guide bar 920 ofsurgical instrument 900. As can be seen, guidebar 920 is comprised of anouter frame member 921, anouter frame member 922, and acentral hub 923.Outer frame member 921 andcentral hub 923 define afirst channel 920A andouter frame member 922 andcentral hub member 923 define asecond channel 920B. As will be explained further later in this specification,first instrument hub 940 is slidably disposed withinfirst channel 920A andsecond instrument hub 950 is slidably disposed withinsecond channel 920B. -
Central hub 923 is comprised of ahub guide member 926, which is a flat planar member. Disposed on the underside and extending perpendicular fromhub guide member 926 isactuator guide member 924.Actuator guide member 924 defines anaperture 925 which includes anactuator tab slot 925A and an actuatorguide structure slot 925B. As will be further explained,actuator tab slot 925A provides an opening withinactuator guide member 924 such that the actuator tab that is associated withhub actuator 960 is able to be rotated throughactuator guide member 924 from engagement with one instrument hub to engagement with the other instrument hub. Actuatorguide structure slot 925B provides clearance troughactuator guide member 924 for the guide structure that is associated withhub actuator 960. As will also be explained,actuator guide member 924 guides the movement ofhub actuator 960 and the slidingfinger ring assembly 930 alongsurgical instrument 900. - Figures 59-63 illustrate
first instrument hub 940 andsecond instrument hub 950. Sincefirst instrument hub 940 is formed similar tosecond instrument hub 950, a detailed discussion will only be provided forsecond instrument hub 950, which can be clearly seen in Figures 59-63.Second instrument hub 950 is comprised of abody portion 952 and aguide portion 954.Body portion 952 is formed in an elongated rectangular shape.Guide portion 954 extends from the bottom ofbody portion 952 and defines aguide slot 954A and an actuatortab engagement slot 954B.Guide slot 954A is formed on both sides ofguide portion 954, as can be clearly seen in Figure 60, and actuatortab engagement slot 954B extends transversely completely throughguide portion 954.Guide slot 954A receives within itouter frame member 922 ofguide bar 920 on one side ofguide portion 954 and receives within it on the other side ofguide portion 954 hub guideplanar member 926 ofcentral hub 923. Thus,second instrument hub 950 is slidably disposed onguide bar 920 withinsurgical instrument 900. Actuatortab engagement slot 954B receives within it hub actuator 960 when the user ofsurgical instrument 900 desires to select the tool associated withsecond instrument hub 950 for use. - As mentioned above,
first instrument hub 940 is formed similar tosecond instrument hub 950 and thus, only a brief description offirst instrument hub 940 will be provided.First instrument hub 940 is also comprised ofbody portion 942 andguide portion 944.Guide portion 944 definesguide slot 944A and actuator tab engagement slot 944B.Guide slot 944A is also formed on both sides ofguide portion 944 and thus,guide portion 944 offirst instrument hub 940 is received withinfirst channel 920A ofguide bar 920 such thatfirst instrument hub 940 is slidably disposed onguide bar 920. Actuator tab engagement slot 944B also receives within it hub actuator 960 when a user ofsurgical instrument 900 desires to select the tool associated withfirst instrument hub 940 for use. - Figures 64-66 illustrate the sliding
finger ring assembly 930. As can be seen, slidingfinger ring assembly 930 is comprised of abody portion 931 and first and second finger rings 931A, 931B, respectively, which are attached at either side ofbody portion 931. Disposed withinbody portion 931 isguide 934, which defines anaperture 934A within it. Attached to the distal end ofguide 934 is actuator guidestructure receiving ring 935. The upper portion ofbody portion 931 and guide 934 define instrumenthub receiving aperture 932, the purpose of which is to allowinstrument hubs finger ring assembly 930, such thathub actuator 960 is able to engage one of the instrument hubs and thus, the instrument hub is able to be moved alongbody portion 910 along with movement of slidingfinger ring assembly 930 alongbody portion 910.Guide 934 and the lower portion ofbody portion 931 define surgical instrument bodyportion receiving aperture 933 which receives the lower body portion ofsurgical instrument 900 within it. Thus, slidingfinger ring assembly 930 is able to be moved alongbody portion 910 ofsurgical instrument 900. As will become clear later in this specification, actuator guidestructure receiving ring 935 receives within it a portion ofhub actuator 960. Thus,hub actuator 960 is structurally mated tofinger ring assembly 930 and is able to rotate within the actuator guidestructure receiving ring 935 offinger ring assembly 930. - Figure 67 illustrates
hub actuator 960. As can be seen,hub actuator 960 is comprised of afinger grip 961, anactuator tab 962, and guidestructure 964.Guide structure 964 has an outer circular circumference and defines afirst guide slot 964A and asecond guide slot 964B. As will become clear, the first and second guide slots alternatively receive within themactuator guide member 924 ofguide bar 920. Ashub actuator 960 is rotated to engage one of the instrument hubs, the longitudinal axis of one of the guide slots will align with the longitudinal axis of theactuator guide member 924. Thus,hub actuator 960 is able to be moved alongguide bar 920 by placingactuator guide member 924 within one of the guide slots defined byguide structure 964. Ashub actuator 960 is rotated, such that the hub actuator engages the other of the instrument hubs, then the other of the guide slots will now align longitudinally withactuator guide member 924, such thathub actuator 960 is again able to be moved alongguide member 924. Thus, the first and second guide slots are used to guidehub actuator 960 alongguide bar 920 whenhub actuator 960 engages one of the instrument hubs insurgical instrument 900. - Disposed on
guide structure 964 isactuator tab 962.Actuator tab 962 extends fromguide structure 964 and is located above the horizontal plane of the upper most portion ofguide structure 964.Actuator tab 962 is received within one ofinstrument hubs surgical instrument 900. Becausehub actuator 960 is rotatably mounted withinfinger ring assembly 930,actuator tab 962 is able to rotate in order to engage one or the other of the instrument hubs. As was mentioned previously,actuator guide member 924 ofguide bar 920 includes anactuator tab slot 925A within it. It is throughactuator tab slot 925A that actuatortab 962 is able to pass throughactuator guide member 924 to engage each of theinstrument hubs actuator guide member 924 includes actuatorguide structure slot 925B. Actuatorguide structure slot 925B receives within it guidestructure 964 ofhub actuator 960. Thus, guidestructure 964 ofhub actuator 960 is able to rotate without being impeded by theactuator guide member 924. - Figure 68 illustrates
hub actuator 960 andfinger ring assembly 930 in an assembled configuration. For purposes of clarity, the sliding instrument hubs and theguide bar 920 are not illustrated. As can be seen, theguide structure 964 ofhub actuator 960 is received within the actuator guidestructure receiving ring 935 offinger ring assembly 930. As such,hub actuator 960 is structurally mated with slidingfinger ring assembly 930 andhub actuator 960 is able to rotate within the slidingfinger ring assembly 930. Figure 68 illustrateshub actuator 960 where it has been rotated such that it would engagefirst actuator hub 940 iffirst actuator hub 940 was present in this illustration. It can be seen that in this position forhub actuator 960, thefirst guide slot 964A ofhub actuator 960 aligns withaperture 934A that is formed withinguide 934 of slidingfinger ring assembly 930. Thus,actuator guide member 924 ofguide bar 920 would be received within alignedaperture 934A andslot 964A such that the slidingfinger ring assembly 930 andhub actuator 960 would be able to be moved alongactuator guide member 924 ofguide bar 920 ofsurgical instrument 900. As can be understood, ifhub actuator 960 was rotated such thatactuator tab 962 would now engage withsecond instrument hub 950,second guide slot 964B would align withaperture 934A in slidingfinger ring assembly 930 such that both thehub actuator 960 and the slidingfinger ring assembly 930 would be able to be moved alongactuator guide member 924 ofguide bar 920. - Figure 69 illustrates the
hub actuator 960, theguide bar 920,first instrument hub 940 andsecond instrument hub 950 in an assembled configuration to illustrate the interaction between the instrument hubs, the guide bar, and the hub actuator. For purposes of clarity, the slidingfinger ring assembly 930 andbody 910 are not illustrated in Figure 69. As can be seen,hub actuator 960 has been rotated such thatactuator tab 962 engages withfirst instrument hub 940 through interaction with actuator tab engagement slot 944B that is formed withinguide portion 944 offirst instrument hub 940. As can be further seen in Figure 69,first instrument hub 940 is slidably mounted onguide bar 920 by placingguide bar 920 withinguide slot 944A defined byguide portion 944 offirst instrument hub 940. Withhub actuator 960 in this position, it can be seen thatfirst guide slot 964A that is formed withinguide structure 964 ofhub actuator 960 is in axial alignment withactuator guide member 924 ofguide bar 920 such thathub actuator 960 is able to be moved alongguide bar 920. Thus, it can be understood that because there is a structural connection betweenhub actuator 960, sliding finger ring assembly 930 (as illustrated in Figure 68 and as discussed previously), andfirst instrument hub 940, as slidingfinger ring assembly 930 is moved distally alongbody portion 910 ofsurgical instrument 900,instrument hub 940 will also be moved along with slidingfinger ring assembly 930.Second instrument hub 950 will not move alongbody portion 910 with slidingfinger ring assembly 930 because, in this position forhub actuator 960, there is no structural connection betweensecond instrument hub 950 and slidingfinger ring assembly 930 throughhub actuator 960. - Figures 70 and 71 provide cross-sectional views of
surgical instrument 900 in an assembled configuration. Figure 70 is a cross-section ofsurgical instrument 900 taken along line 70-70 of Figure 52 and Figure 71 is a cross section ofsurgical instrument 900 taken along ling 71-71 of Figure 52. Both Figures 70 and 71 illustratehub actuator 960 in a position where it has engagedfirst instrument hub 940. - Figures 72-75 illustrate the sheath
stress relief member 980 of the present embodiment. As can be seen, sheathstress relief member 980 is comprised of aconical portion 982 and acircular portion 984.Circular portion 984 and a portion ofconical portion 982 are mounted withindistal end 910A ofbody portion 910 as can be clearly seen in Figure 70. Anotch 986 is provided inconical portion 982 that cooperates with structure ondistal end 910A ofbody 910 to provide stress relief for the structural connection between stress relief member 980 (and thus a sheath (not shown) that is attached toconical portion 982 of stress relief member 980) andbody 910. As can be seen, an aperture extends through sheathstress relief member 980 and is aligned with an aperture that is included indistal end 910A ofbody 910 such that the surgical tools that are associated withsurgical instrument 900 may extend throughbody portion 910 and sheathstress relief member 980 and into the sheath that would be attached to the distal end of the surgical instrument. - In operation, a user of
surgical instrument 900 would rotateactuator tab 960 to engage one of theinstrument hubs hub actuator 960, the selected instrument hub can be moved alongbody portion 910 ofsurgical instrument 900 when the slidingfinger ring assembly 930 is moved alongbody portion 910. To select the other instrument hub for use, the user ofsurgical instrument 900 rotateshub actuator 960 such that it engages with that instrument hub. Thus, a user ofsurgical instrument 900 is able to selectively engage a surgical tool for use withinsurgical instrument 900. Whereas the non-engaged instrument hub is not locked-out from use, it can not be moved alongbody portion 910 ofsurgical instrument 900 through movement of slidingfinger ring assembly 930. - Figures 76-79 illustrate a tenth embodiment for a tool actuator assembly in accordance with the present invention. Figures 76 and 77 illustrate the
tool actuator assembly 1000. As can be seen in Figure 76,tool actuator assembly 1000 is comprised of abody 1010, a firsttool receiving member 1040, a secondtool receiving member 1050, and a tool lock-out switch 1030.Tool actuator assembly 1000 also includescatheter 1020, which is attached todistal end 1010A oftool actuator assembly 1000. -
Body 1010 is a hollow structure that receives through it a first surgical tool, which is illustrated asinjection needle 1070 in Figure 76, and a second surgical tool, which is illustrated assnare instrument 1060 in Figure 76.Injection needle 1070 is received within firsttool receiving member 1040 and extends throughbody 1010 andcatheter 1020 where, in an operative position,needle tip 1074 ofinjection needle 1070 extends beyond thedistal end 1020A ofcatheter 1020.Injection needle 1070 includesinjection port 1072 which is utilized in well-known methods.Injection needle 1070 is able to be moved manually in the directions as illustrated in Figure 76, such thatneedle tip 1074 may be extended fromcatheter 1020 and retracted intocatheter 1020. - Second
tool receiving member 1050 is internally threaded at itsproximal end 1052. As such,snare instrument 1060, which can be a well-known snare instrument, can be threaded into secondtool receiving member 1050. As such,distal end 1060A ofsnare instrument 1060 is externally threaded so that it may be received within secondtool receiving member 1050.Snare rod 1062 ofsnare instrument 1060 extends fromsnare instrument 1060 through secondtool receiving member 1050 andbody 1010 oftool actuator assembly 1000. As such,snare loop 1064, which is located atdistal end 1062A ofsnare rod 1062, is able to be extended from, and retracted into,catheter 1020. -
Snare rod 1062 is attached to slidingfinger ring assembly 1066 ofsnare instrument 1060 and thus is able to be extended from, and retracted into,catheter 1020 by moving slidingfinger ring assembly 1066 along the body ofsnare instrument 1060 in the directions as illustrated in Figure 76. As will be explained further below, tool lock-out switch 1030, which is rotatably mounted onbody 1010 and which extends intobody 1010, is utilized to lock-out from operation one of the surgical tools from operation while the other of the surgical tools is being utilized by the physician. - Figure 76 illustrates
tool actuator assembly 1000 being utilized with aninjection needle 1070 and asnare instrument 1060, however, the present invention is not limited to only being utilized with these two particular tools.Tool actuator assembly 1000 can be utilized with any known surgical tool and can be utilized to lock-out from operation one surgical tool while the other surgical tool is being utilized by the physician. - Figure 78 illustrates the internal working components of
tool actuator assembly 1000. As can be seen, withinbody 1010 tool lock-out switch 1030 is comprised of ahub 1032 which includes atrough 1034 that extends around a portion of the outer circumference ofhub 1032.Trough 1034 provides for a reduced diameter forhub 1032 along the portion ofhub 1032 wheretrough 1034 is located. The purpose oftrough 1034 will be explained below. Also associated with tool lock-out switch 1030 are first lockingmember 1036 andsecond locking member 1038. Each of the first andsecond locking members body 1010 within channels that are formed withinbody 1010. As such,first locking member 1036 is contained withinfirst body channel 1037 andsecond locking member 1038 is contained withinsecond body channel 1039. First lockingmember 1036 is disposed betweeninjection needle 1070 andhub 1032 andsecond locking member 1038 is disposed betweensnare rod 1062 andhub 1032. Thus,first locking member 1036 is operably associated withinjection needle 1070 andhub 1032 andsecond locking member 1038 is operably associated withsnare rod 1062 andhub 1032. - Figure 79 provides greater detail for the assembled configuration between
needle 1070, first lockingmember 1036, andhub 1032. As can be seen in Figure 79,needle 1070 is provided with a joint 1078 within it. Needle joint 1078 provides for a decreased diameter at the center of the joint than that for the needle along the needle's shaft.Snare rod 1062 is also provided with a similar joint that may be seen in Figure 78 as snare joint 1068. - In operation, tool lock-
out switch 1030 locks-out from operation one of the surgical tools extending throughtool actuator assembly 1000 by engaging a locking member with its associated tool shaft at the joint of the tool shaft. The reduced diameter of the joint of the tool shaft allows for the locking member to be positioned within this area of reduced diameter in the shaft in order to prevent the tool shaft from being extended further throughtool actuator assembly 1000 and thus extended from thedistal end 1020A ofcatheter 1020. Due to the providing oftrough 1034 withinhub 1032, as one of the locking members is engaged with its associated tool to lock-out the operation of the tool, the other of the locking members will be positioned within thetrough 1034 ofhub 1032 and thus will not be forced byhub 1032 into contact with the shaft of its associated tool. Thus, the second surgical tool can be easily moved distally and proximally throughbody portion 1010 oftool actuator assembly 1000 such that the tool can be utilized by the surgeon in performed a procedure. - Figure 78 illustrates a position for lock-
out switch 1030 whereinjection needle 1070 has been locked-out from operation by first lockingmember 1036. As can be seen, first lockingmember 1036 has been forced into engagement with needle joint 1078 through contact between first lockingmember 1036 and theouter circumference 1032A ofhub 1032. As can also be seen when lock-out switch 1030 is in this position,second locking member 1038 is received withintrough 1034 ofhub 1032. Thus,second locking member 1038 is not rigidly engaged withsnare rod 1062 and thus,snare rod 1062 is able to be freely moved withinbody 1010. - As can be understood, in Figure 78, if
hub 1032 was rotated in a clockwise direction, this clockwise rotation of 1032 would then positionfirst locking member 1036 withintrough 1034 andsecond locking member 1038 would be caused to be forced out oftrough 1034 and would be positioned againstouter circumference 1032A ofhub 1032. After this clockwise rotation ofhub 1032, first lockingmember 1036 would no longer be in rigid contact withinjection needle 1070 and thusinjection needle 1070 would now be able to be freely moved withinbody 1010 such that it may be extended from, and retracted into,catheter 1020. It can also be understood that nowsecond locking member 1038 will be forced into rigid contact withsnare rod 1062 at its connection joint 1068 and thus this rigid connection betweensecond locking member 1038 and snare joint 1062 will preventsnare rod 1062 from being moved freely withinbody 1010. Thus, afterhub 1032 has been rotated in this clockwise direction, nowinjection needle 1070 may be freely used by the surgeon to perform a procedure andsnare 1060 has now been locked-out from use by the surgeon. Theend regions 1034A and 1034B oftrough 1034 can be formed with camming surfaces such the locking members may easily ride up and out of thetrough 1034 as thehub 1032 is rotated from one lock-out position to another lock-out position. - The disclosed embodiments are illustrative of the various ways in which the present invention may be practiced. Other embodiments can be implemented by those skilled in the art without departing from the spirit and scope of the present invention.
Claims (30)
- A multi-function surgical instrument comprising:a tubular body;a finger ring assembly slidably mounted on said body;a shaft slidably mounted within a distal end of said body;a first surgical tool disposed within said shaft and said body and connected to said finger ring assembly;a second surgical tool disposed within said shaft and said body and connected to a proximal end of said body; andan actuator member slidably mounted on said body and attached to said shaft.
- The multi-function surgical instrument of claim 1 wherein:said body defines a guiding slot at a distal end of said body; andsaid actuator member includes:a head portion, said head portion disposed outside of said body;an elongated stem portion, said stem portion extending from said head portion and partially disposed within said body; anda slot guide, said slot guide disposed on said elongated stem portion and received within said guiding slot.
- The multi-function surgical instrument of claim 2 wherein said slot guide includes a first guide tab and a second guide tab and wherein said first and second guide tabs are disposed on opposing sides of said elongated stem portion.
- The multi-function surgical instrument of claim 1 wherein said actuator member includes:an engagement head portion disposed proximal to said finger ring assembly;a shaft attachment portion disposed at a distal end of said body; anda connection member, said connection member attached to said engagement head portion and said shaft attachment portion and disposed within said body.
- The multi-function surgical instrument of claim 4 further comprising a biasing member, said biasing member disposed within said body at a proximal end of said body and located proximal to said actuator member and said finger ring assembly.
- A multi-function surgical instrument comprising:a body;a finger ring assembly slidably mounted on said body;a shaft attached to a distal end of said body;a first surgical tool disposed within said shaft and said body and connected to said finger ring assembly;an actuator member rotatably mounted in said body and operably associated with said finger ring assembly; anda second surgical tool disposed within said shaft and said body and operably connected to said actuator member.
- The multi-function surgical instrument of claim 6 wherein said actuator member is a circular gear and wherein a pulley cable extends from said finger ring assembly to said gear to operably couple said gear to said finger ring assembly, said pulley cable including teeth at a distal end thereof, said teeth engageable with said gear.
- The multi-function surgical instrument of claim 7 wherein said second surgical tool includes a hub, said hub slidably disposed within said body and including teeth, said teeth engageable with said gear.
- The multi-function surgical instrument of claim 6 wherein said actuator member is a gear, said gear defining a channel at a first end thereof and including teeth at a second end thereof and wherein a pulley cable extends from said finger ring assembly to said gear to operably couple said gear to said finger ring assembly, said pulley cable including a stop member at a distal end thereof and said pulley cable received within said channel.
- The multi-function surgical instrument of claim 9 further comprising a biasing member, said biasing member disposed within said body and cooperating with said gear to bias said gear in a first position where a distal end of said second surgical tool is disposed within said sheath.
- The multi-function surgical instrument of claim 6 wherein said actuator member is mounted in said body proximal to said finger ring assembly and wherein said actuator member includes a tool attachment portion and an engagement portion, said second surgical tool attached to said tool attachment portion and said engagement portion engageable with said finger ring assembly.
- The multi-function surgical instrument of claim 11 wherein said tool attachment portion includes a first arm member and a second arm member wherein both said first arm member and said second arm member include an aperture defined therein and wherein said tool attachment portion has a first longitudinal axis and said engagement portion has a second longitudinal axis wherein said first longitudinal axis is off-set from said second longitudinal axis.
- A multi-function surgical instrument comprising:a body;a housing attached to a distal end of said body;a finger ring assembly slidably mounted on said body;a first surgical tool disposed within said body and extending through said housing, said first surgical tool connected to said finger ring assembly and including a coupler; anda second surgical tool slidably mounted within said housing;
wherein said coupler engages said second surgical tool when said first surgical tool is moved distally through said housing. - The multi-function surgical instrument of claim 13 further including a biasing member, said biasing member disposed in said housing.
- The multi-function surgical instrument of claim 13 wherein said second surgical tool includes a hub and wherein said coupler engages said hub.
- The multi-function surgical instrument of claim 15 wherein said hub includes a channel and wherein said first surgical tool is received within said channel.
- A multi-function surgical instrument comprising:a body;a first instrument hub slidably disposed within said body;a second instrument hub slidably disposed within said body;a finger ring assembly slidably mounted on said body; anda surgical tool actuator assembly mounted within said finger ring assembly and selectively engageable with said first and second instrument hubs.
- The multi-function surgical instrument of claim 17 wherein said surgical tool actuator assembly is rotatably mounted within said finger ring assembly and includes a top switching member and a bottom switching member, said top switching member and said bottom switching member engageable with each other such that when said top switching member is manually rotated by a user to engage one of said first and second instrument hubs said bottom switching member is automatically rotated to engage the other of said first and second instrument hubs.
- The multi-function surgical instrument of claim 18 wherein said top switching member includes an instrument hub actuating member and a bottom switch member engagement tab, said instrument hub actuating member and said bottom switch member engagement tab attached to a first side of said top switching member and disposed within said finger ring assembly.
- The multi-function surgical instrument of claim 18 wherein said bottom switching member includes an instrument hub locking member and a top switch engagement member.
- The multi-function surgical instrument of claim 17 wherein said finger ring assembly includes a first housing and a second housing and wherein said surgical tool actuator assembly includes a first actuator button slidably disposed within said first housing and a second actuator button slidably disposed within said second housing.
- The multi-function surgical instrument of claim 21 wherein said first instrument hub includes a first hub engagement member and said second instrument hub includes a second hub engagement member and wherein said first hub engagement member is engageable with said first actuator button and wherein said second hub engagement member is engageable with said second actuator button.
- The multi-function surgical instrument of claim 17 wherein said surgical tool actuator assembly includes a guide structure and an actuator tab, said actuator tab disposed on said guide structure.
- The multi-function surgical instrument of claim 23 wherein said guide structure defines a first guide slot having a first longitudinal axis and a second guide slot having a second longitudinal axis.
- The multi-function surgical instrument of claim 17 further comprising a shaft stress relief member, said shaft stress relief member attached to a distal end of said body.
- The multi-function surgical instrument of claim 23 wherein said finger ring assembly includes an actuator guide structure receiving ring and wherein said guide structure is received within said actuator guide structure receiving ring.
- The multi-function surgical instrument of claim 24 wherein said body includes a guide bar and wherein said guide bar is received within said first and second guide slots.
- A surgical tool actuator assembly comprising:a body, said body including:a first tool receiving member; anda second tool receiving member;a tool lock-out switch, said tool lock-out switch rotatably mounted in said body and selectively engageable with said first tool receiving member and said second tool receiving member wherein when said tool lock-out switch is engaged with one of said first or second tool receiving members a surgical tool which is disposed within said engaged receiving member is locked-out from use for a user of the tool.
- The surgical tool actuator assembly of claim 28 wherein said tool lock-out switch includes a hub mounted in said body and a first locking member disposed between said hub and said first tool receiving member and a second locking member disposed between said hub and said second tool receiving member.
- The surgical tool actuator assembly of claim 29 wherein said hub includes a trough along a portion thereof.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US192568 | 1988-05-11 | ||
US09/192,568 US6162209A (en) | 1998-11-17 | 1998-11-17 | Multi-function surgical instrument tool actuator assembly |
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EP1002499A2 true EP1002499A2 (en) | 2000-05-24 |
EP1002499A3 EP1002499A3 (en) | 2001-03-07 |
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EP99122079A Expired - Lifetime EP1002499B1 (en) | 1998-11-17 | 1999-11-16 | Multi-function surgical instrument |
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EP (1) | EP1002499B1 (en) |
JP (1) | JP4090164B2 (en) |
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Also Published As
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US6162209A (en) | 2000-12-19 |
JP4090164B2 (en) | 2008-05-28 |
US20110046612A1 (en) | 2011-02-24 |
CA2290160A1 (en) | 2000-05-17 |
US7217264B2 (en) | 2007-05-15 |
EP1002499B1 (en) | 2007-01-03 |
DE69934657T2 (en) | 2007-10-18 |
AU759737B2 (en) | 2003-04-17 |
DE69934657D1 (en) | 2007-02-15 |
US8764734B2 (en) | 2014-07-01 |
US20070250048A1 (en) | 2007-10-25 |
AU5598299A (en) | 2000-05-18 |
US6589231B1 (en) | 2003-07-08 |
US20030195492A1 (en) | 2003-10-16 |
US20140257196A1 (en) | 2014-09-11 |
EP1002499A3 (en) | 2001-03-07 |
US9327081B2 (en) | 2016-05-03 |
CA2290160C (en) | 2007-05-22 |
US7799017B2 (en) | 2010-09-21 |
JP2000152942A (en) | 2000-06-06 |
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